Rna with a combination of unmodified and modified nucleotides for protein expression

ABSTRACT

The invention relates to a polyribonucleotide with a sequence that codes a protein or protein fragment, wherein the polyribonucleotide comprises a combination of unmodified and modified nucleotides, wherein 5 to 50% of the uridine nucleotides and 5 to 50% of the cytidin nucleotides are modified uridine nucleotides or modified cytidin nucleotides.

The invention relates to a polyribonucleotide, in particular messengerRNA, which contains a combination of unmodified and modifiednucleotides, for protein expression and the use of such RNAs for thetherapy of diseases and for diagnostic procedures.

Messenger RNAs (mRNA) are polymers which are built up of nucleosidephosphate building blocks mainly with adenosine, cytidine, uridine andguanosine as nucleosides, which as intermediate carriers bring thegenetic information from the DNA in the cell nucleus into the cytoplasm,where it is translated into proteins. They are thus suitable asalternatives for gene expression.

The elucidation of the biochemical processes in the cell and theelucidation of the human genome have revealed connections betweendeficient genes and diseases. Hence there has long been the desire toheal diseases due to deficient genes by gene therapy. The expectationswere high, but attempts at this as a rule failed. A first approach togene therapy consisted in bringing the intact DNA of a deficient ordefective gene into the cell nucleus in a vector in order to achieve theexpression of the intact gene and thus the provision of the missing ordefective protein. These attempts were as a rule not successful and theless successful attempts were burdened with substantial side effects, inparticular elevated tumorigenesis.

Furthermore, there are diseases which are due to a lack of proteins or aprotein defect, without this being attributable to a genetic defect. Insuch a case also, consideration is being given to producing the relevantproteins in vivo by administration of DNA. The provision of factorswhich play a part in the metabolism and are destroyed or inhibited forpathological or non-pathological reasons could also be effected by azero or low side effect nucleic acid therapy.

The use has also already been proposed of mRNAs for the therapy ofhereditary diseases in order to treat gene defects which lead todiseases. The advantage in this is that the mRNA only has to beintroduced into the cytoplasm of a cell, but does not have to beinserted into the nucleus. Insertion into the nucleus is difficult andinefficient; moreover there is a considerable risk of the chromosomalDNA being altered if the vector or parts thereof become incorporatedinto the genome.

Admittedly it could be shown that in vitro transcribed messenger RNA canin fact be expressed in mammalian tissue, however further hurdles arosein the attempt to use mRNA for the therapy of diseases. The lack ofstability of the mRNA had the effect that the desired protein could notbe made available in sufficient quantity in the mammalian tissue. Afurther substantial disadvantage resulted from the fact that mRNAtriggers considerable immunological reactions. It is presumed that thesestrong immune reactions arise through binding to Toll-like receptorssuch as TLR3, TLR7, TLR8 and helicase RIG-1.

In order to prevent an immunological reaction, it was proposed in WO2007/024708 to use RNA wherein one of the four ribonucleotides isreplaced by a modified nucleotide. In particular, it was investigatedhow mRNA behaves when the uridine is totally replaced by pseudouridine.It was found that such an RNA molecule is significantly lessimmunogenic. However, the biological activity of these products was notyet sufficient for successful therapy. Moreover, it was found that RNAsequences wherein two or more types of nucleotides are fully replaced bymodifications can only be made with difficulty or not at all.

In order to be able to provide the body with necessary or beneficialproteins and/or to treat a disease due to missing or deficient proteinswith nucleic acids, it is desirable to have a nucleic acid availablewhich can transfect cells, which remains stable in the cell for longenough and provides a sufficient quantity of protein, so thatexcessively frequent administration is avoided. At the same time,however, this nucleic acid must not cause immunological reactions to asignificant extent.

Hence a purpose of the present invention was to provide an agent whichis suitable for the therapy of diseases caused by deficient or defectivegenes or diseases caused by missing or defective proteins, or which canin vivo produce necessary or beneficial proteins, which triggers amarkedly diminished or no immune response, is stable in a physiologicalenvironment, i.e. is not degraded immediately after administration andoverall is suitable as an agent for therapy. Further, it was a purposeof the invention to provide an agent for the therapy of diseases whichcan be positively influenced by in vivo production of proteins.

This problem is solved with a polyribonucleotide as defined in claim 1.Particularly suitable is mRNA which encodes a protein or proteinfragment, a defect or lack whereof is disadvantageous to the body, orexpression whereof is of advantage to the body. When the term“polyribonucleotide” or “mRNA” is used below, unless the context statesotherwise, it should always be assumed that this is a polyribonucleotideor an mRNA which encodes a protein or protein fragment which isconnected with an illness or lack, as described above, or encodes aprotein or protein fragment which is beneficial or supportive to thebody.

It has surprisingly been found that the aforesaid problems can be solvedwith ribonucleic acid or polyribonucleotides (also generally referred tobelow as RNA), in particular with messenger RNA (mRNA), if an RNA isused which contains both unmodified and also modified nucleotides, itbeing essential that a predetermined content of the uridine and thecytidine nucleotides respectively is present in modified form.

Further, it has surprisingly been observed that RNA wherein two types ofnucleotides are each partially replaced with modified nucleotides showshigh translation and transfection efficiency, i.e. the RNA transfectsmore cells and produces more of the encoded protein per cell than waspossible with known RNA. In addition, the RNA modified according to theinvention is active for longer than the RNA or unmodified RNA known fromthe state of the art.

The advantages achieved with the RNA according to the invention areobtained neither with unmodified nor with fully modified RNA. It hasbeen found that both diminished immunogenicity and also increasedstability can be achieved if the content of modified uridine andcytidine nucleotides in the mRNA is specifically set and is at least 5%and not more than 50% for each. If an mRNA with no modifications isused, this is extremely immunogenic, while when all uridine and cytidinenucleotides are present in modified form the biological activity is toolow for use for therapeutic purposes to be possible. RNA in which thecontent of modified nucleotides is very high can be produced under verydifficult conditions or not at all. Thus it has been established that anucleotide mixture which contains only pseudouridine instead of uridineand only modified cytosine and/or modified adenosine cannot yield anyRNA sequence. Surprisingly, however, RNA sequences which are modified inthe manner according to the invention can be produced easily withreasonable efficiency.

In addition, it has been found that the nature of the modification iscritical. The mRNAs modified according to the invention show lowimmunogenicity and have a long lifetime.

It has been found that the stability of the RNA according to theinvention is markedly increased compared to previously used nucleicacids. Thus it has been established that the mRNA according to theinvention is detectable 10 days after the transfection in a quantity 10times higher than unmodified RNA. As well as high transfection rates,the increased lifetime above all enables the use of the mRNA accordingto the invention for therapeutic purposes, since the high stability andhence long lifetime makes it possible to effect administration at longertime intervals which are thus also acceptable to the patients.

Thus according to the invention a particularly advantageous agent fortherapeutic purposes is provided. The RNA according to the inventionfulfills the requirements that are placed on a product to be used intherapy: as RNA it needs only to be introduced into the cytoplasm andnot into the cell nucleus to develop its activity, the danger ofintegration into the genome does not exist, the type of modificationaccording to the invention largely prevents an immune reaction and inaddition the modification protects the RNA from rapid degradation. Hencewith the RNA according to the invention it is possible to generate or toregenerate physiological functions in tissues, e.g. to restore in vivofunctions which had failed owing to a deficient or defective gene, andhence to treat diseases caused by deficient or defective genes. Further,it has surprisingly been found that polyribonucleotides according to theinvention can favorably influence diseases in that proteins are producedin vivo which can directly or indirectly have an influence on the courseof the disease. Hence according to the invention polyribonucleotides canalso be provided which encode factors which are beneficial andsupportive to the body in general or in a specific situation, e.g.growth factors, angiogenesis factors, stimulators, inducers, enzymes orother biologically active molecules.

The invention is explained in more detail in the following descriptionand the attached diagrams.

FIG. 1 shows the effect of different nucleotide modifications on theimmunogenicity and stability of various mRNAs. FIG. 1A is a diagram onwhich the TNF-α level after administration of various RNAs withdifferently modified nucleotides is plotted. Unmodified and up to 25%singly modified RNA leads to a high level of inflammatory markers andshows the high immunogenicity of this RNA, while for RNA doubly modifiedaccording to the invention the inflammatory markers are present intolerable amount. FIGS. 1B and 1C show the biological activity(transfection efficiency and expression) of mRNA modified in variousways in human cells and mouse cells as the percentage of the cellspositive for red fluorescing protein (RFP) and the quantity of RFP percell. The diagrams show that the proteins encoded by unmodified, singlymodified and completely modified RNA can only be detected at a lowerpercentage content, while the RNA partly doubly modified according tothe invention yields significantly higher quantities of protein owing toits greater stability.

FIG. 2 shows the higher stability and longer duration of expression formultiply modified mRNA. FIGS. 2A and 2B each show diagrams on which theduration of expression of various modified and unmodified mRNAs isplotted. FIG. 2C shows data for RNA immunoprecipitation for unmodifiedRNA, singly modified RNA and multiply modified RNA. FIG. 2D showsdiagrams in which the immunogenicity of various mRNAs after in vivointravenous administration is plotted. The data show that an RNA doublymodified according to the invention displays a combination of highstability and low immunogenicity.

FIG. 3 shows various test results which were obtained afterintratracheal aerosol application of modified SP-B mRNA in SP-Bconditionally deficient mice. FIG. 3A shows bioluminescence images ofthe lung of mice treated with unmodified RNA and multiply modified RNA.It can clearly be seen that a sufficient quantity of protein is stillalso expressed after 5 days only by RNA modified according to theinvention, while with unmodified RNA the expression is already low after3 hours. FIG. 3B shows a diagram in which the flux is plotted againstthe time after transfection. It can clearly be discerned that themodification according to the invention prolongs the duration ofexpression. FIG. 3C shows the dosing scheme for SP-B mRNA. FIG. 3D showsa diagram which presents the survival rate for mice which were treatedwith modified mRNA compared to mice which were treated with controlmRNA, the survival rate in mice treated with RNA according to theinvention being markedly longer. FIG. 3E shows an immunostaining inwhich it can be seen that with RNA according to the invention whichencodes SP-B the SP-B in SP-B deficient mice could be reconstituted.FIG. 3F shows as the result of a semi-quantitative Western blot analysisthe distribution of proteins in cell-free BALF supernatant. FIGS. 3G andH show images of lung histology preparations and bronchoalveolar lavagepreparations from mice treated according to 3C. While lung and lavagepreparations from mice which had received control RNA showed the lungdamage usual for SP-B deficiency, the preparations from mice treatedwith RNA according to the invention were non-pathological. FIG. 3I showsa diagram concerning the lung tolerance over time. The lung function wasretained over a longer period on treatment with RNA according to theinvention, while lung damage was found in animals treated with controlRNA.

FIG. 4 shows a diagram in which the fluorescence intensity of the RFPproduced was plotted against time for unmodified and differentlymodified mRNAs. The modified mRNA is translated later and less stronglycompared to the unmodified mRNA.

FIG. 5 shows three diagrams in which inflammatory markers for micetreated with different mRNAs are plotted. It can clearly be discernedthat RNA modified according to the invention causes no inflammatoryreactions, while unmodified RNA leads to a strong immune reaction.

FIG. 6 shows diagrams in which different typical lung parameters areplotted for mice treated with different mRNAs according to theinvention. The parameters are tissue elasticity (HL), tissue damping(GL), tissue inertia, airway resistance (Rn) and lung tissue compositionEta (GL/HL). For the RNAs according to the invention, none of theparameters was worsened compared to the positive control group.

FIG. 7 shows the expression capacity of differently modified mRNA in adiagram in which the percentage content of RFP positive cells is plottedfor mRNA with a different content of modified nucleotides. Thecomparison shows that only mRNA modified according to the inventionleads to long-lasting expression, while mRNA modified not according tothe invention expresses to a lesser extent both in human cells and alsoin mouse cells.

FIG. 8 shows the expression capacity of differently modified mRNA in adiagram in which the percentage content of RFP positive cells is plottedfor mRNA with differently modified nucleotides. The comparison showsthat only mRNA modified according to the invention leads to long-lastingexpression, while mRNA modified not according to the invention expressesto a lesser extent both in human cells and also in mouse cells.

FIG. 9 shows the stability of freeze-dried RNA according to theinvention.

FIG. 10A shows a diagram in which the transfection efficiency is plottedfor various modified nucleotides. It can clearly be discerned that thehighest transfection efficiency is attained with RNA wherein 10% of theuridine nucleotides and 10% of the cytidine nucleotides and optionallyalso 5% of further nucleotides are modified. FIG. 10B shows a diagram inwhich the TNF-α production as a marker for the immunological reaction isplotted for RNA with differently modified nucleotides. These are theresults of an ELISA of human PBMCs which were each transfected with 5 μgof mRNA. Unless otherwise stated, the modification rate was 10% in each.

It is clearly discernible that RNA wherein between 5 and 50% of theuridine nucleotides and cytidine nucleotides are modified has a markedlyreduced immunogenicity compared to unmodified RNA.

FIG. 11 shows the results of various tests with which the stability andimmunogenicity of mRNA modified according to the invention, whichencodes EPO, was measured. Diagram 11(a) shows the content oferythropoietin which is detectable 14 days after administration of mRNAencoding EPO which is modified in different ways. It is clearlydiscernible that after 14 days the content of EPO in mice into whichmRNA modified according to the invention was injected is 4.8 timeshigher than in untreated mice, but also 4.8 times higher than in micetreated with unmodified RNA and is still 2.5 times higher than in micetreated with singly modified RNA.

Diagram 11(b) shows hematocrit values 14 days and 28 days afteradministration of EPO-encoding mRNA with different modifications. Thediagram clearly shows that mice treated with mRNA modified according tothe invention have a considerably higher hematocrit value.

In the diagrams of FIG. 11( c) the production of the factors typical foran immunological reaction is plotted. It is found that all fourinflammatory markers are elevated with the administration of unmodifiedmRNA, while with RNA modified according to the invention animmunological reaction is hardly detectable.

The diagrams of FIG. 11( d) show the corresponding values for IFN-α andIL-12, which are also inflammatory markers. Here also it is found thatmRNA modified according to the invention causes practically noimmunological reaction, in contrast to unmodified mRNA.

FIG. 12 shows a diagram in which the survival rate of three groups ofmice which were given SP-B mRNA modified according to the inventiontwice in one week (B) or twice a week for 28 days (C), or in thecomparison group modified EGFPLuc mRNA (A) is plotted. It is found thatthe mice only survive as long as they are given SP-B mRNA (B, C).Without provision of SP-B mRNA, the mice die (A).

FIG. 13 shows cytokine levels in the bronchoalveolar lavage of mice 8hours after administration of unmodified SP-B mRNA, SP-B mRNA modifiedaccording to the invention or SP-B plasmid DNA. The results show that incontrast to the intratracheal administration of unmodified mRNA orplasmid DNA, which each lead to a marked rise in the inflammatorymarkers IFNγ and IL-12, on administration of SP-B mRNA modifiedaccording to the invention the inflammatory markers are practically notelevated compared to the untreated group or to the group treated withperfluorocarbon.

FIG. 14 shows hematocrit values as obtained after repeatedadministration of mEPO mRNA modified according to the invention. Theresults show that the repeated administration of mEPO mRNA modifiedaccording to the invention is well tolerated and results inlong-persisting elevation of the hematocrit.

FIG. 15 shows the luciferase expression of cells which were incubatedwith titanium implants which were provided with coatings containingdifferent forms of RNA modified according to the invention. It was foundthat RNA modified according to the invention which was contained in acoating of delayed release polymer which had been applied onto titaniumplates and which was gradually released therefrom did not lose itsactivity.

FIG. 16 shows the luciferase expression for coatings applied ontotitanium implants which contained modified mRNA. It was found that theprotein expression for mRNA modified according to the invention was farhigher than for untreated RNA, but was also higher than for plasmid DNA.

FIGS. 17A and 17B respectively show the relative content of RFP-positivecells and the relative RFP expression of mRNA which has micro-RNAbinding sites for micro-RNA 142-3p. It was found that the content ofRFP-positive cells for RNA having micro-RNA binding sites was lower andthe expression of the encoded protein was considerably lower in thecells which contained the corresponding micro-RNA 142-3p.

FIG. 18 shows the sequence of an RNA modified by incorporation ofmicro-RNA binding sites, which encodes RFP. The RFP sequence is shownwith a gray background. The fourfold tandem repetition of the micro-RNAbinding site for the micro-RNA 142-3p (with light gray background) withthe spacing sequences (no background) is underlined.

According to the invention, a polyribonucleotide molecule with partiallymultiply modified nucleotides, a partially multiply modified mRNA, anIVT mRNA, and the use of the RNA molecules for the production of a drugfor the treatment of diseases due to deficient or defective genes or forthe treatment of diseases which can be moderated or cured by theprovision of proteins in vivo, such as factors, stimulators, inducers orenzymes, are provided. In a further embodiment, the mRNA according tothe invention is combined with target binding sites, targeting sequencesand/or with micro-RNA binding sites, in order to allow activity of thedesired mRNA only in the relevant cells. In a further embodiment, theRNA according to the invention is combined with micro-RNAs or shRNAsdownstream of the 3′ polyA tail. In a further embodiment, RNA whoseduration of action has been adjusted or extended by further specificmodifications is provided.

Thus a subject of the invention is an RNA with increased stability anddecreased immunogenicity. The RNA according to the invention can be madein a manner known per se. As a rule it is made by transcription of a DNAwhich encodes the intact or desired protein which can influence anillness or the lack or deficient form whereof causes a disease.

In the context of the present invention, RNA should be understood tomean any polyribonucleotide molecule which, if it comes into the cell,is suitable for the expression of a protein or fragment thereof or istranslatable to a protein or fragment thereof. The term “protein” hereencompasses any kind of amino acid sequence, i.e. chains of two or moreamino acids which are each linked via peptide bonds and also includespeptides and fusion proteins.

The RNA according to the invention contains a ribonucleotide sequencewhich encodes a protein or fragment thereof whose function in the cellor in the vicinity of the cell is needed or beneficial, e.g. a proteinthe lack or defective form whereof is a trigger for a disease or anillness, provision whereof can moderate or prevent a disease or anillness, or a protein which can promote a process which is beneficialfor the body, in a cell or its vicinity. As a rule, the RNA according tothe invention contains the sequence for the complete protein or afunctional variant thereof. Further, the ribonucleotide sequence canencode a protein which acts as a factor, inducer, regulator, stimulatoror enzyme, or a functional fragment thereof, where this protein is onewhose function is necessary in order to remedy a disorder, in particulara metabolic disorder or in order to initiate processes in vivo such asthe formation of new blood vessels, tissues, etc. Here, functionalvariant is understood to mean a fragment which in the cell can undertakethe function of the protein whose function in the cell is needed or thelack or defective form whereof is pathogenic. In addition, the RNAaccording to the invention can also have further functional regionsand/or 3′ or 5′ noncoding regions. The 3′ and/or 5′ noncoding regionscan be the regions naturally flanking the encoded protein or elseartificial sequences which contribute to the stabilization of the RNA.Those skilled in the art can discover the sequences suitable for this ineach case by routine experiments.

In a preferred embodiment, the RNA contains an m7GpppG cap, an internalribosome entry site (IRES) and/or a polyA tail at the 3′ end inparticular in order to improve translation. The RNA can have furtherregions promoting translation. Critical for the RNA according to theinvention is its content of modified nucleotides.

An RNA according to the invention with increased stability anddiminished immunogenicity is obtained by using for the productionthereof a nucleotide mixture wherein the content of the modifiedcytidine nucleotides and the modified uridine nucleotides is set. TheRNA according to the invention is preferably produced with a nucleotidemixture which contains both unmodified and also modified nucleotides,where 5 to 50% of the cytidine nucleotides and 5 to 50% of the uridinenucleotides are modified. The adenosine- and guanosine-containingnucleotides can be unmodified. A nucleotide mixture can also be usedwherein some of the ATPs and/or GTPs are also modified, where theircontent should not exceed 20% and where their content, if present,should preferably lie in a range from 0.5 to 10%.

Hence in a preferred embodiment an mRNA is provided which has 5 to 50%of modified cytidine nucleotides and 5 to 50% of uridine nucleotides and50 to 95% of unmodified cytidine nucleotides and 50 to 95% of unmodifieduridine nucleotides, and the adenosine and guanosine nucleotides can beunmodified or partially modified, and they are preferably present inunmodified form.

Preferably 10 to 35% of the cytidine and uridine nucleotides aremodified and particularly preferably the content of the modifiedcytidine nucleotides lies in a range from 7.5 to 25% and the content ofthe modified uridine nucleotides in a range from 7.5 to 25%. It has beenfound that in fact a relatively low content, e.g. only 10% each, ofmodified cytidine and uridine nucleotides can achieve the desiredproperties, under the precondition that these are the modificationsaccording to the invention.

The nature of the modification of the nucleosides has an effect on thestability and hence the lifetime and biological activity of the mRNA.Suitable modifications are set out in the following table:

Base modification Sugar modification Naturally Name (5-position)(2′-position) in mRNA Uridine 5-methyluridine 5′-triphosphate (m5U) CH₃— no 5-idouridine 5′-triphosphate (I5U) I — no 5-bromouridine5′-triphosphate (Br5U) Br — no 2-thiouridine 5′-triphosphate (S4U) S (in2 position) — no 4-thiouridine 5′-triphosphate (S2U) S (in 4 position) —no 2′-methyl-2′-deoxyuridine 5′-triphosphate (U2′m) — CH₃ yes2′-amino-2′-deoxyuridine 5′-triphosphate (U2′NH2) — NH₂ no2′-azido-2′-deoxyuridine 5′-triphosphate (U2′N3) — N₃ no2′-fluoro-2′-deoxyuridine 5′-triphosphate (U2′F) — F no Cytidine5-methylcytidine 5′-triphosphate (m5C) CH₃ — yes 5-idocytidine5′-triphosphate (I5U) I — no 5-bromocytidine 5′-triphosphate (Br5U) Br —no 2-thiocytidine 5′-triphosphate (S2C) S (in 2 position) — no2′-methyl-2′-deoxycytidine 5′-triphosphate (C2′m) — CH₃ yes2′-amino-2′-deoxycytidine 5′-triphosphate (C2′NH2) — NH₂ no2′-azido-2′-deoxycytidine 5′-triphosphate (C2′N3) — N₃ no2′-fluoro-2′-deoxycytidine 5′-triphosphate (C2′F) — F no AdenosineN6-methyladenosine 5′-triphosphate (m6A) CH₃ (in 6 position) — yesN1-methyladenosine 5′-triphosphate (m1A) CH₃ (in 1 position) — no2′-O-methyladenosine 5′-triphosphate (A2′m) — CH₃ yes2′-amino-2′-deoxyadenosine 5′-triphosphate (A2′NH2) — NH₂ no2′-azido-2′-deoxyadenosine 5′-triphosphate (A2′N3) — N₃ no2′-fluoro-2′-deoxyadenosine 5′-triphosphate (A2′F) — F no GuanosineN1-methylguanosine 5′-triphosphate (m1G) CH₃ (in 1 position) — no2′-O-methylguanosine 5′-triphosphate (G2′m) — CH₃ yes2′-amino-3′-deoxyguanosine 5′-triphosphate (G2′NH2) — NH₂ no2′-azido-2′-deoxyguanosine 5′-triphosphate (G2′N3) — N₃ no2′-fluoro-2′-deoxyguanosine 5′-triphosphate (G2′F) — F no

For the RNA according to the invention, either all uridine nucleotidesand cytidine nucleotides can each be modified in the same form or else amixture of modified nucleotides can be used for each. The modifiednucleotides can have naturally or not naturally occurring modifications.A mixture of various modified nucleotides can be used. Thus for exampleone part of the modified nucleotides can have natural modifications,while another part has modifications not occurring naturally or amixture of naturally occurring modified and/or not naturally occurringmodified nucleotides can be used. Also, a part of the modifiednucleotides can have a base modification and another part a sugarmodification. In the same way, it is possible that all modifications arebase modifications or all modifications are sugar modifications or anysuitable mixture thereof. By variation of the modifications, thestability and/or duration of action of the RNA according to theinvention can be selectively adjusted.

In one embodiment of the invention, at least two different modificationsare used for one type of nucleotide, where one type of the modifiednucleotides has a functional group via which further groups can beattached. Nucleotides with different functional groups can also be used,in order to provide binding sites for the attachment of differentgroups. Thus for example a part of the modified nucleotides can bear anazido group, an amino group, a hydroxy group, a thiol group or someother reactive group which is suitable for reaction under predefinedconditions. The functional group can also be such that it can undercertain conditions activate a naturally present group capable ofbinding, so that molecules with functions can be coupled. Nucleotideswhich are modified so that they provide binding sites can also beintroduced as adenosine or guanosine modifications. The selection of theparticular suitable modifications and the selection of the binding sitesto be made available depends on what groups are to be introduced andwith what frequency these are to be present. Thus the content of thenucleotides provided with functional and/or activating groups depends onhow high the content of groups to be coupled is to be and can easily bedetermined by those skilled in the art. As a rule, the content ofnucleotides modified with functional and/or activating groups, ifpresent, is 1 to 25% of the modified nucleotides. Those skilled in theart can if necessary determine the most suitable groups in each case andthe optimal content thereof by routine experiments.

It has been found that particularly good results can be achieved whenthe RNA according to the invention 2′-thiouridine as a modifieduridine-containing nucleotide. Furthermore, it is preferred that the RNAaccording to the invention contains 5′-methylcytidine as a modifiedcytidine nucleotide. These two nucleotides are therefore preferred. Alsopreferred is a combination of these two modifications. In an especiallypreferred embodiment, these two nucleotides are each present at acontent of 10 to 30%. Nucleotides modified in another way can optionallyalso be present, as long as the total content of modified nucleotidesdoes not exceed 50% of the particular nucleotide type.

Preferred is a polyribonucleotide wherein 5 to 50%, particularlypreferably 5 to 30% and in particular 7.5 to 25% of the uridinenucleotides are 2′-thiouridine nucleotides, and 5 to 50%, particularlypreferably 5 to 30% and in particular 7.5 to 25% of the cytidinenucleotides are 5′-methylcytidine nucleotides, where the adenosine andguanosine nucleotides can be unmodified or partially modifiednucleotides. In a preferred embodiment, this mRNA according to theinvention additionally has a 7′-methylguanosine cap and/or a poly(A)end. Thus in a preferred embodiment the mRNA is produced in its matureform, i.e. with a GppG cap, an IRES and/or a polyA tail.

The optimal types and contents of modified uridine nucleotides andcytidine nucleotides for a specific RNA can be determined with routineexperiments. In this context an mRNA whose immunogenicity is so low thatthe treated organism is not stressed and which has a predeterminedstability and hence predetermined duration of expression is described asoptimal. Methods for the testing and determination of these propertiesare known to those skilled in the art and are described below and in theexamples.

The RNA according to the invention can be produced in a manner known perse. A method wherein the mRNA according to the invention is produced byin vitro transcription from a mixture of ATP, CTP, GTP and UTP, wherein5 to 50%, preferably 5 to 30% and in particular 7.5 to 25% of thecytidine nucleotides and 5 to 50%, preferably 5 to 30% and in particular7.5 to 25% of the uridine nucleotides are modified and the rest isunmodified is for example suitable. Guanosine and adenosine nucleosides,in particular adenosine, can optionally also be modified. However, themodification of UTP and CTP in the stated range is essential for theinvention. If the content of modified UTP and/or modified CTP is loweror higher, the advantageous properties are no longer achieved. Thus ithas been found that outside the claimed ranges the mRNA is no longer sostable. Moreover, with a lower content of modification immunologicalreactions are to be expected. In order to set the suitable ratio ofunmodified and modified nucleotides, the RNA is appropriately made usinga nucleotide mixture, the nucleoside contents whereof are partlymodified and partly unmodified in accordance with the desired ratio,where according to the invention at least 5% of the uridine nucleosidesand at least 5% of the cytidine nucleosides are modified, but in totalnot more than 50% of uridine nucleosides and cytidine nucleosidesrespectively are modified. Further nucleosides, i.e. adenosine andguanosine, can be modified, however an upper limit of 50% modification,preferably 20%, should also not be exceeded for these nucleosides.Preferably only the appropriate contents of the uridine nucleosides andcytidine nucleosides are modified.

The nucleosides to be modified can have modifications such as are alsoto be found in naturally occurring nucleosides, e.g. methylations orbinding variations, but also “synthetic”, i.e. not occurring in nature,modifications or a mixture of nucleosides with natural and/or syntheticmodifications can be used. Thus naturally modified nucleosides of atleast one type can be combined with synthetically modified nucleosidesof the same type or another type or else naturally and syntheticallymodified nucleosides of one type with only naturally, only syntheticallyor mixed naturally/synthetically modified nucleosides of another type,where “type” here refers to the type of the nucleosides, i.e. ATP, GTP,CTP or UTP. In many cases, as stated above, for the improvement ofimmunogenicity and stability or for adjustment of properties it can bebeneficial to combine modified nucleosides with functional groups, whichprovide binding sites, with non-functionally modified nucleosides. Themost suitable type or combination can easily be found by those skilledin the art by routine experiments such as are for example also statedbelow. Particularly preferably, 2-thiouridine and 5-methylcytidine areused as modified nucleosides. If functionally modified nucleosides aredesired, 2′-azido and 2′-amino nucleosides are preferably considered.

The length of the mRNA used according to the invention depends on thegene product or protein or protein fragment which is to be provided orsupplemented. Hence the mRNA can be very short, e.g. have only 20 or 30nucleotides, or else corresponding to the length of the gene haveseveral thousand nucleotides. Those skilled in the art can select thesuitable sequence each time in the usual way.

What is essential is that the function of the protein causing a disease,of the protein moderating or preventing a disease or of the proteincontrolling a beneficial property, for which the mRNA is to be used, canbe provided.

2′-Thiouridine is preferably used as the modified uridine-containingnucleotide for the production of the RNA according to the invention.Furthermore, it is preferable to use 5′-methylcytidine as the modifiedcytidine nucleotide. Hence for the production of the RNA according tothe invention a nucleotide mixture which as well as ATP and GTPrespectively contains 95 to 50% of unmodified CTP and 95 to 50% ofunmodified UTP and 5 to 50% of 2′-thiouridine nucleotides and 5 to 50%of methylcytidine nucleotides is preferably used. Hence apolyribonucleotide wherein 5 to 50%, preferably 5 to 30% and inparticular 7.5 to 25% of the uridine nucleotides are 2′-thiouridinenucleotides and 5 to 50%, preferably 5 to 30% and in particular 7.5 to25% of the cytidine nucleotides are 5′-methylcytidine nucleotides andthe adenosine and guanosine nucleotides are unmodified nucleotides isparticularly preferred. Such a combination leads to the production of apartially modified RNA which is characterized by particularly highstability. It could be shown that RNA which was produced with anucleotide mixture which as CTP and UTP contained 5 to 50% of2-thiouridine and 5-methylcytidine nucleotides respectively isespecially stable, i.e. had a lifetime increased up to 10-fold comparedto unmodified RNA or RNA modified in known manner.

In a further preferred embodiment, 1 to 50%, preferably 2 to 25%, of the5 to 50% modified uridine or cytidine nucleotides are nucleotides whichhave binding site-creating or activating groups as a modification, i.e.0.5 to 20%, preferably 1 to 10% of the cytidine nucleotides and/oruridine nucleotides can have a modification which creates a bindingsite, such as for example azido, NH, SH or OH groups. Through thiscombination, an RNA which is both particularly stable and also versatileis provided.

Further, it is preferred that the polyribonucleotide molecule built upof unmodified and modified nucleotides has a 7′-methylguanosine capand/or a poly(A) end. In addition, the RNA can also have additionalsequences, e.g. non-translated regions and functional nucleic acids,such as are well known to those skilled in the art.

The RNA according to the invention is preferably provided as in vitrotranscribed RNA (IVT RNA). The materials necessary for performing the invitro transcription are known to those skilled in the art and availablecommercially, in particular buffers, enzymes and nucleotide mixtures.The nature of the DNA used for the production of the RNA according tothe invention is also not critical; as a rule it is cloned DNA.

As stated above, an RNA, in particular mRNA, which has a predeterminedcontent of modified uridine nucleosides and modified cytidinenucleosides is provided. The optimal content of modified uridinenucleosides and cytidine nucleosides for a specific mRNA can bedetermined by routine experiments which are well known to those skilledin the art.

The RNA according to the invention is preferably used for the therapy ofdiseases or for the provision of proteins beneficial to the body. Whenthe RNA according to the invention is used for the therapy of diseases,it preferably has the in vitro transcript for a protein or proteinfragment, a defect or lack whereof leads to a disease condition or theprovision whereof leads to the moderation of an illness. For theproduction of the RNA according to the invention, a DNA is preferablyused which encodes a protein or protein fragment, a defect or lackwhereof leads to a disease or is connected with an illness. In oneembodiment, the DNA of a gene, a defect or lack whereof leads to adisease or illness, is used for the production of the RNA according tothe invention. In another embodiment, a DNA which encodes a protein thepresence, perhaps temporary, whereof is beneficial or curative for anorganism is used for the production of the RNA according to theinvention. Here any state wherein physical and/or mental/psychologicaldisorders or changes are subjectively and/or objectively present, orwhere the abnormal course of physical, mental or psychological processesmakes medical care necessary and may lead to inability to work isregarded as a disease or illness.

Here a protein or protein fragment the presence whereof can moderate anillness or be beneficial or supportive to the body are understood tomean proteins or protein fragments which, without a genetic defect beingpresent, are to be made fully or temporarily available to the body sincethey are missing either because of disorders of some kind or because ofnatural circumstances or because they can benefit the body under certainconditions, e.g. in the treatment of defects or in the context ofimplantation. These also include altered forms of proteins or proteinfragments, i.e. forms of proteins which alter in the course of themetabolism, e.g. matured forms of a protein, etc. Proteins which play apart in growth processes and angiogenesis, which are for examplenecessary in controlled regeneration and can then be formed specificallyby introduction of the mRNA according to the invention, can also beprovided. This can for example be useful in growth processes or for thetreatment of bone defects, tissue defects and in the context ofimplantation and transplantation.

It has been found that the mRNA modified according to the invention canadvantageously be used in order to promote the ingrowth of implantedprostheses. If it is available on the surface of prostheses to beinserted such as tooth implants, hip endoprostheses, knee endoprosthesesor vertebral fusion bodies, the mRNA according to the invention canrelease factors which can promote the ingrowth, new formation of bloodvessels and other functions which are necessary for the newly insertedprostheses. Thus for example the administration of biologically activesubstances such as growth factors such as BMP-2 or angiogenesis factorsin the context of implantation of prostheses or thereafter is known.Since biological substances very often have extremely short half-lives,it was previously necessary to use very high dosages, which burdens thepatient with severe side effects. According to the invention, thisdisadvantage is avoided since using the RNA according to the inventionthe desired and/or needed proteins can be used selectively and suitablydosed. This decreases or even completely spares the patient the sideeffects. In this embodiment, the RNA according to the invention whichencodes desired and/or needed substances such as growth factors,angiogenesis factors etc. can be applied onto the implant in a coatingreleasing the RNA in a measured manner and then released graduallytherefrom in a measured manner, so that the cells in the vicinity of theimplant can continuously or intermittently produce and if necessaryrelease the desired factors. Carriers, as a rule biocompatible,synthetic, natural or mixed natural-synthetic polymers, the releaseproperties whereof can be specifically adjusted, are well known and thusneed no more detailed explanation here. Polylactide orpolylactide/glycolide polymers are for example used. In this way it ispossible selectively to release the desired factors continuously,intermittently, over a longer or shorter time and at the desired site.

In the context of the present invention, a deficient or defective geneor deficiency or lack are understood to mean genes which are notexpressed, incorrectly expressed or not expressed in adequate quantityand as a result cause diseases or illnesses, e.g. by causing metabolicdisorders.

The RNA according to the invention can appropriately be used in any casewhere a protein, which would naturally be present in the body but is notpresent or is present in deficient form or in too small a quantitybecause of gene defects or diseases, is to be provided to the body.Proteins and the genes encoding them, the deficiency or defect whereofare linked with a disease, are known. Various proteins and genes in caseof a lack whereof the RNA according to the invention can be used arelisted below.

TABLE 2 Diseases for which the administration of mRNA according to theinvention can be indicated: Organ Defect Lung surfactant protein Bdeficiency Lung ABCA3 deficiency Lung cystic fibrosis Lung alpha-1antitrypsin deficiency Plasma proteins clotting defects such ashemophilia A and B Plasma proteins complement defects such as protein Cdeficiency Plasma proteins thrombotic thrombocytopenic purpura (TPP,ADAMTS 13 deficiency) Plasma proteins congenital hemochromatoses (e.g.hepcidin deficiency) Severe combined immunodeficiencies (SCID) (T, B andNK cells) X-chromosomally inherited combined immunodeficiencies (X-SCID)ADA-SCID (SCID due to lack of adenosine deaminase) SCID with RAG1mutation SCID with RAG2 mutation SCID with JAK3 mutation SCID with IL7Rmutation SCID with CD45 mutation SCID with CD3δ mutation SCID with CD3εmutation SCID with purine nucleoside phosphorylase deficiency (PNPdeficiency) Disease Defect or mutation Septic granulomatoses(granulocytes) X-chromosomal recessive CGD mutation of the gp91-phoxgene CGD cytochrome b positive type 1 mutation of the p47-phox gene CGDcytochrome b positive type 2 mutation of the p67-phox gene CGDcytochrome b negative mutation of the p22-phox gene Other storagediseases mutation in the glucocerebrosidase gene Gaucher's diseasemutation in the GALC gene Krabbe's disease lysosomal storage diseasesmucopolysaccharidoses Type Defect Specific name Glycogen storagediseases I (a-d) Ia: glucose-6-phosphatase Von Gierke's disease Ib, Ic,Id: glucose-6-phosphate translocase II lysosomal α-glucosidase Pompe'sdisease III glycogen debranching enzyme Cori's disease IV 1,4-α-glucanbranching enzyme Andersen's disease V muscle glycogen phosphorylaseMcArdle's disease VI glycogen phosphorylase/ Hers disease phosphorylasekinase system (liver and muscle) VII phosphofructokinase (muscle)Tarui's disease VIII liver phosphorylase IX (a-c) liver phosphorylase XcAMP-act. phosphorylase XI GLUT-2 defect Fanconi-Bickel syndrome 0 UDPglycogen synthase Other storage diseases mutation in theglucocerebrosidase Gaucher's disease gene mutation in the GALC geneKrabbe's disease lysosomal storage diseases mucopolysaccharidoses

Other diseases based on defective genes are stated below:

Type Variant Clinical features Defective enzyme I-H Hurler-Pfaundlersyndrome dysmorphia (gargoylism), α-L-iduronidase cognitive retardation,skeletal malformation (dysostosis), corneal clouding, decreased growth,hernias, hepatomegaly I-S Scheie's disease not mentally retarded,α-L-iduronidase skeletal malformation (dysostosis), corneal clouding,heart valve faults I-H/S Hurler/Scheie variants mentally between I-H andI-S α-L-iduronidase II Hunter's syndrome moderate cognitive retardation,iduronate sulfate skeletal malformation (dysostosis), silfataseconsiderable somatic changes, premature deafness III Sanfilippo type Acognitive retardation, dysmorphia, heparan sulfate syndrome cornealclouding can be lacking, sulfamidase type B frequently hearingimpairment, α-N-acetylglucose rapid progression amidase type Cacetyl-CoA; α- glucosaminid-N- acetyl transferase type DN-acetylglucosamine- 6-sulfate sulfatase IV Morquio syndrome type Anormal cognitive development, N-acetylglucosamine- skeletal malformation(dysostosis) 6-sulfate sulfatase very marked, no corneal clouding type Bmild form of type A β-galactosidase V now: type I-S, see above VIMaroteaux-Lasny syndrome normal cognitive development, N-acetylgalactos-severe skeletal malformation amine-4-sulfate (dysostosis), cornealclouding, sulfatase decreased growth VII Sly syndrome moderatedysmorphia and skeletal β-glucuronidase malformations, corneal clouding,normal to limited intelligence

Thus the above table shows examples of genes in which a defect leads toa disease which can be treated by transcript replacement therapy withthe RNA according to the invention. In particular here, hereditarydiseases can be mentioned which for example affect the lungs, such asSPB deficiency, ABCA3 deficiency, cystic fibrosis and α1-antitrypsindeficiency, which affect plasma proteins and cause clotting defects andcomplement defects, immune defects such as for example SCID, septicgranulomatosis and storage diseases. In all these diseases, a protein,e.g. an enzyme, is defective, which can be treated by treatment with theRNA according to the invention, which makes the protein encoded by thedefective gene or a functional fragment thereof available.

Thus, examples of proteins which can be encoded by the RNA according tothe invention are erythropoietin (EPO), growth hormone (somatotropin,hGH), cystic fibrosis transmembrane conductance regulator (CFTR), growthfactors such as GM-SCF, G-CSF, MPS, protein C, hepcidin, ABCA3 andsurfactant protein B. Further examples of diseases which can be treatedwith the RNA according to the invention are hemophilia A/B, Fabry'sdisease, CGD, ADAMTS13, Hurler's disease, X chromosome-mediatedA-γ-globulinemia, adenosine deaminase-related immunodeficiency andrespiratory distress syndrome in the newborn, which is linked with SP-B.Particularly preferably, the mRNA according to the invention containsthe sequence for surfactant protein B (SP-B) or for erythropoietin.Further examples of proteins which can be encoded by RNA modifiedaccording to the invention are growth factors such as BMP-2 orangiogenesis factors.

A further use field for the RNA according to the invention arises fordiseases or illnesses wherein proteins are no longer or not formed inthe body, e.g. because of organ failure. At present, a recombinantprotein is administered for replacement in such diseases. According tothe invention, RNA is now provided for this so that the replacement ofthe missing protein can take place at the level of the transcript. Thishas several advantages. If the protein has glycosylations, then thereplacement at the transcript level has the effect that theglycosylation typical in humans takes place in the body. With proteinsthat are recombinant, i.e. normally produced in microorganisms, theglycosylation is as a rule different from that in the body wherereplacement is to be effected. This can lead to side effects. Generallyit can be assumed that the protein expressed from the RNA according tothe invention is identical with the endogenous protein as regardsstructure and glycosylation, which is as a rule not the case withrecombinant proteins.

Examples of proteins replacement or introduction whereof can bedesirable are functional proteins such as erythropoietin and growthfactors such as somatotropin (hGH), G-CSF, GM-CSF and thrombopoietin.

A further field in which the RNA according to the invention can be usedis the field of regenerative medicine. Through disease processes orthrough aging, degenerative diseases arise which can be treated andmoderated or even cured by introduction of proteins produced too littleor not at all owing to the disease or aging processes. By introductionof the relevant RNA encoding these proteins, the degenerative processcan be halted or regeneration can even be initiated. Examples of thisare growth factors for tissue regeneration which can be used e.g. ingrowth disorders, in degenerative diseases such as osteoporosis,arthrosis or impaired wound healing. Here the RNA according to theinvention offers not only the advantage that the missing protein can beprovided selectively and in the correct dosage but in addition it ispossible to provide the protein in a time window. Thus for example withimpaired wound healing, the relevant healing factor or growth factor canbe provided for a limited time by dosed administration of the RNA. Inaddition, via mechanisms to be explained later, it can be arranged thatthe RNA is selectively brought to the site of its desired action.

Examples of factors which can be expressed with the RNA according to theinvention so as to have a regenerative action are fibroblast growthfactor (FGF), e.g. FGF-1-23, transforming growth factor (TGF), e.g.TGF-α and TGF-β, BMPs (bone morphogenetic protein), e.g. BMP1 to 7, 8a &b, 10 & 15, platelet-derived growth factor (PDGF), e.g. PDGF-A, PDGF-B,PDGF-C and PDGF-D, epidermal growth factor (EGF), granulocyte-macrophagecolony stimulating factor (GM-CSF), vascular endothelial growth factor(VEGF-A to F and PIGF), insulin-like growth factors, e.g. IgF1 and IgF2,hepatocyte growth factor (HGF), interleukins, e.g. interleukin-1B, IL-8and IL-1 to 31, nerve growth factor (NGF) and other factors whichstimulate the formation of erythrocytes, neutrophils, blood vessels,etc.

The RNA according to the invention can also be selectively used in thefield of cancer diseases. Through the expression of tailor-made T cellreceptors in T lymphocytes which recognize specific tumor-associatedantigens, these can become still more effective. It has already beenshown that in principle mRNA can be successfully used in this field.However until now its use was prevented by the immunogenic effectsalready described above. With the less immunogenic and highly stable RNAprovided according to the invention, it is now possible to express Tcell receptors appropriately.

RNA according to the invention can also be used to express transcriptionfactors which ensure that somatic cells are reprogrammed into embryonicstem cells. Examples of this are O-cp3/4, Sox2, KLF4 and c-MYC. StableRNA, especially mRNA, according to the invention which encodes thesetranscription factors can thus lead to the production of stem cellswithout creating the side effects which can occur with the previouslyconsidered gene transfer via viral or non-viral vectors.

An advantage of using the RNA according to the invention is that, incontrast to the use of DNA vectors, the duration of the treatment isadjustable. In the case of the induction of stem cells, it is as a ruledesirable that the transcription factors are only transiently active, inorder to reprogram somatic cells into stem cells. Through dosedadministration of the relevant RNA encoding the transcription factorsthe activity is controllable over time. In contrast to this, with thepreviously known methods there is the danger of integration of the genesadministered, which leads to complications, e.g. tumorigenesis, andmoreover renders it impossible to control the duration.

In the vaccines field, the RNA according to the invention also offersnew possibilities. The standard development of vaccines depends onkilled or weakened pathogens. More recently, DNA which encodes a proteinof the pathogen has also come under consideration. The production ofthese vaccines is laborious and very time-consuming. Often side effectsarise and lead to vaccinations being refused. With the mRNA according tothe invention, it is possible to provide a vaccine which does not havethe problems associated with pathogens or DNA. In addition, such avaccine can be produced very quickly as soon as the antigen sequences ofa pathogen are known. This is particularly advantageous under the threatof pandemics. Thus in one embodiment of the present invention, an RNA isprovided which encodes an antigenic part of a disease pathogen, e.g. asurface antigen. It is also possible to provide an mRNA which encodes anamino acid sequence which has a combination of several epitopes,optionally linked by spacer sections. A combination withimmunomodulating substances is also possible, either through the RNAencoding a fusion protein or as a combination of nucleic acids.

Furthermore, the RNA according to the invention can also encode proteinswhich as factors, stimulators, inducers, etc. have an influence on thecourse of disease. Examples are diseases which are not directlyattributable to a gene defect but wherein the disease process can bepositively influenced by means of mRNA expression. Examples are:erythropoietin for stimulation of the formation of erythrocytes, G-CSFor GM-SCF for the formation of neutrophils, growth factors for theformation of new blood vessels, for bone and wound healing as factorsfor “tissue engineering”, treatment of tumors by induction of apoptosisor by formation of proteinaceous cell poisons, e.g. diphtheria toxin A,by induction of pluripotent stem cells (iPS) etc.

It has been found that only a polyribonucleotide according to theinvention, which has a predetermined content of modified and unmodifiednucleotides, has low immunogenicity with at the same time highstability. In order to be able to determine the optimal combination ofmodified and unmodified nucleotides for a certain polyribonucleotide,immunogenicity and stability can be determined in a manner known per se.For the determination of the immunogenicity of an RNA, various methodswell known to those skilled in the art can be used. A very suitablemethod is the determination of inflammatory markers in cells as areaction to the administration of RNA. Such a method is described in theexamples. Cytokines which are associated with inflammation, such as forexample TNF-α, IFN-α, IFN-β, IL-8, IL-6, IL-12 or other cytokines knownto those skilled in the art are normally measured. The expression of DCactivation markers can also be used for the estimation ofimmunogenicity. A further indication of an immunological reaction is thedetection of binding to the Toll-like receptors TLR-3, TLR-7 and TLR-8and to helicase RIG-1.

The immunogenicity is as a rule determined in relation to a control. Ina common method, either the RNA according to the invention or an RNAthat is unmodified or modified in another way is administered to cellsand the secretion of inflammatory markers in a defined time interval asa reaction to the administration of the RNA is measured. As the standardused for comparison, either unmodified RNA can be used, in which casethe immune response should be lower, or RNA which is known to causelittle or no immune response, in which case the immune response to theRNA according to the invention should then lie in the same range and notbe elevated. With the RNA according to the invention it is possible tolower the immune response compared to unmodified RNA by at least 30%, asa rule at least 50% or even 75% or even to prevent it completely.

The immunogenicity can be determined by measurement of the aforesaidfactors, in particular by measurement of the TNF-α and IL-8 levels andthe binding capacity to TLR-3, TLR-7, TLR-8 and helicase RIG-1. In orderthereby to establish whether an mRNA has the desired low immunogenicity,the quantity of one or more of the aforesaid factors afteradministration of the polyribonucleotide concerned can be measured. Thusfor example a quantity of the mRNA to be tested can be administered tomice via the caudal vein or i.p. and then one or more of the aforesaidfactors can be measured in the blood after a predefined period, e.g.after 7 or 14 days. The quantity of factor is then related to thequantity of factor which is present in the blood of untreated animals.For the determination of the immunogenicity it has been found veryvaluable to determine the binding capacity to TLR-3, TLR-7, TLR-8 and/orhelicase RIG-1. The TNF-α levels and IL-8 levels also provide very goodindications. With the mRNA according to the invention, it is possible tolower the binding capacity to TLR-3, TLR-7, TLR-8 and RIG-1 by at least50% compared to unmodified RNA. As a rule it is possible to lower thebinding to said factors by at least 75% or even by 80%. In preferredembodiments, the binding capacity to TLR-3, TLR-7, TLR-8 and RIG-1 liesin the same range for the mRNA according to the invention and foranimals to which no mRNA was administered. In other words, the mRNAaccording to the invention causes practically no inflammatory orimmunological reactions.

In every case, the RNA according to the invention has such lowimmunogenicity that the general condition of the patient is notaffected. A slight increase in the aforesaid factors can thus betolerated as long as the general condition does not worsen as a result.Further properties of the mRNA according to the invention are itsefficiency and stability. For this, transcription efficiency,transfection efficiency, translation efficiency and duration of proteinexpression are important and can be determined by methods known per se.

The transcription efficiency indicates how efficiently RNA can beproduced from DNA. Here problems can arise with the use of a highcontent of modified nucleotides. The RNA modified according to theinvention can be produced with high transcription efficiency.

In order to obtain stable and adequate expression of the proteinsencoded by the RNA, it is important that sufficient RNA reaches thedesired cells. This can be determined in that after administration oflabeled RNA the content of RNA which has reached the cells is determinedby measurement of the labeling. Flow cytometry can be used for thedetermination of the labeling. When labeling is effected with afluorescent molecule, the transfection efficiency can be calculated, forexample as the percentage of the cell population wherein thefluorescence intensity is higher compared to control cells which wereonly treated with PBS. It has been found that the RNA modified accordingto the invention can be produced effectively, in contrast to RNA whereintwo or more nucleotide types have been 100% replaced by modifiednucleotides, and that the transfection efficiency for RNA according tothe invention, wherein only a part of the nucleotides is modified, isfar higher than with RNA wherein any one type of nucleotides is 100%modified.

The translation efficiency designates the efficiency with which the RNAis translated into the protein. The higher the translation efficiency,the lower can be the dose of RNA that then has to be used for thetreatment. The translation efficiency can be determined by comparing theproportion of translation for RNA modified according to the inventionwith the translation ratio for unmodified RNA. As a rule, thetranslation efficiency with the RNA according to the invention issomewhat lower than with unmodified RNA. This is however more thancompensated by the far higher stability which is manifested in theduration of the protein expression.

The RNA according to the invention in particular provides for highstability, which results in long-continuing protein expression.Particularly when the RNA modified according to the invention isintended for the treatment of diseases due to gene defects, the longerit remains in the cell the more valuable it is. The more rapidly the RNAis degraded, the more rapidly the protein expression ends and the moreoften the RNA must be administered. Conversely, with a stable RNA whichremains in the cell for a long time the frequency of dosing can begreatly reduced. It has been found that RNA modified according to theinvention is stably expressed for up to 4 weeks.

For other embodiments, i.e. when RNA is only intended for temporaryexpression, the duration of the protein expression can be adjusted byinfluencing the stability.

A further valuable property of the RNA according to the invention isthus that the duration of action can be adjusted selectively via thestability so that the duration of the protein expression can be tailoredso that it takes place in a desired time window. Secondly, a verylong-acting RNA can be used where this is necessary. The RNA modifiedaccording to the invention, expression whereof can last up to 4 weeks,is thus ideally suited for the treatment of chronic diseases since hereit only has to be given every 4 weeks. For embodiments wherein the RNAencodes factors which are to be supplied to the body over a prolongedperiod in order to moderate or prevent diseases, the high stability andlong-lasting protein expression is also advantageous, e.g. for the useof RNA encoding erythropoietin. The RNA according to the invention canalso especially advantageously be used for the treatment of hemophilia.Here it was previously necessary to administer the missing factorweekly. With the provision of the RNA according to the invention, thefrequency of administration can be reduced, so that RNA encoding thefactor now only has to be given every 2 or even every 4 weeks.

The stability of the mRNA according to the invention can be determinedby methods known per se. Particularly suitable are methods for thedetermination of the viability of cells which contain RNA modifiedaccording to the invention in comparison to cells which containunmodified or fully modified RNA, e.g. in comparison to RNA that isunmodified or modified in known manner. The production of the encodedprotein over time can also be monitored. Here stability of an RNA isunderstood to mean that when it has been introduced into the cell, theRNA which can express the desired protein or is translatable into theprotein or a functional fragment thereof, remains capable of expressionover a prolonged period, is not immediately degraded and is notinactivated.

A method for testing the stability and the survival time of RNA in acell thus consists in determining how long a protein encoded by the RNAis detectable in the cell or performs its function. Methods for this aredescribed in the examples. Thus for example an mRNA with a sequenceencoding a reporter molecule can be introduced into the cell, optionallytogether with an RNA encoding a desired protein and after predefinedtime periods the presence of reporter molecule and optionally proteinare then determined. Suitable reporter molecules are well known in thestate of the art and those commonly used can also be used here. In apreferred embodiment, RFP, red fluorescing protein, is used as thereporter molecule.

As stated above, the RNA according to the invention can be used fortherapy so that in the cell into which the RNA is introduced a proteincan be formed which is naturally not expressed to the desired extent orat all. Here the RNA according to the invention can be used both whenthe protein is not formed owing to a deficiency of a gene and also inthe cases when owing to a disease a protein is not formed or in caseswhere the introduction of the protein is advantageous for the body. TheRNA can also be used for supplementing a protein which is not expressedto an adequate extent. The dose used in each case depends on thefunction which the RNA is to fulfill. As stated above, the duration ofaction of the RNA according to the invention can be deliberatelyadjusted. The duration of the treatment depends on the particularindication. If the RNA is used for the chronic therapy of a disease dueto a deficient gene, the duration of action will be as long as possible,while with other indications it can be deliberately adjusted to a timewindow.

According to a particularly preferred embodiment, an IVT mRNA whichencodes the surfactant protein B is used as the RNA. When this proteinis deficient in mammals, it results in the development of therespiratory distress syndrome of the premature and newborn. In thenewborn, this syndrome often leads to death owing to a lung disease. Theuse of a multiply modified in vitro transcribed mRNA encoding SP-Bwherein 5 to 50% of the uridine nucleosides and 5 to 50% of the cytidinenucleosides are modified results in the protein being formed and thedisease being moderated or cured.

According to a further preferred embodiment, an IVT mRNA which encodeserythropoietin is used as the RNA. Erythropoietin is a very importantprotein for the body which for example in kidney diseases is no longeravailable in adequate quantity and therefore must be supplied.Recombinant erythropoietin, which has been produced in microorganisms oranimal cells and hence has a glycosylation not occurring naturally, isat present used for this. With the use of the recombinant EPO there werein rare cases severe side effects, for example erythrocyte aplasia.

The IVT mRNA provided according to the invention contains a ribonucleicacid which encodes erythropoietin, wherein 5 to 50% of the uridinenucleotides and 5 to 50% of the cytidine nucleotides are modified. In aparticularly preferred embodiment, an EPO-encoding mRNA wherein 15 to25% of the uridine nucleotides and 15 to 25% of the cytidine nucleotidesare modified is provided. It has been found that this mRNA has markedlyreduced immunogenicity compared to unmodified RNA. At the same time itdisplays a transfection efficiency of over 90% and a stability such thatthe hematocrit value is still elevated after 14 days. Since the EPOproduced by the RNA according to the invention in the body has thecorrect glycosylation, side effects are not to be expected. Throughtargeted intermittent administration of the EPO-encoding RNA modifiedaccording to the invention, the hematocrit value could be kept at thedesired level for a prolonged period.

According to the invention, a non-immunogenic stable RNA is providedwhich is usable in vivo in mammals and provides the necessary protein ina form which is very similar if not identical to the naturally presentendogenous protein and in particular has the endogenous glycosylation.

The mRNA according to the invention can be used directly as such.However, there is also the possibility of further modifying the mRNA inorder to introduce further beneficial properties. Firstly, the mRNA canbe modified by attaching other coding or non-coding sequences to thecoding strand. Secondly, it can also be modified by binding furthermolecules to functional groups provided in the modified nucleotides.

In one embodiment, the mRNA according to the invention can be combinedwith targeting ligands which bind to surface receptors specific for thetarget cells, so that a receptor-mediated transfection of the targetcell is possible. For this firstly vehicles which are suitable for theintroduction of mRNA into cells, or else the mRNA itself can be modifiedwith a ligand. Examples of suitable vehicles for the introduction ofmRNA into cells are cationic agents. These include cationic lipids,cationic polymers or also nanoparticles, nanocapsules, magneticnanoparticles and nanoemulsions. Suitable vehicles are known to thoseskilled in the art and described in the specialist literature. Suitableligands are also well known to those skilled in the art and described inthe literature and available. As ligands for example transferrin,lactoferrin, clenbuterol, sugar, uronic acids, antibodies, aptamers,etc. can be used.

However, the mRNA itself can also be modified with a ligand. For this,mRNAs with modified nucleosides that bear a primary amino group or anazido group in the 2′ position of the ribose are preferred. Examples canbe found in the table above. Such modifications are particularlypreferred since they contribute to the biological activity. Via thesemodifications, the ligand can easily be incorporated by amide formationor “click” chemistry, e.g. by bioconjugate techniques.

In a further embodiment, an RNA sequence which can bind to proteins,e.g. receptors, (aptamer) is introduced at the 5′ end of the mRNA. Thisprocedure has the advantage that the ligand can already be introduceddirectly into the matrix at the DNA level and cloned and introduced intothe mRNA by the IVT. Hence subsequent modification of the mRNA with theligand is no longer necessary.

In a further embodiment, the mRNA is modified by additional modificationwith inert polymers, e.g. polyethylene glycol (PEG). Methods for thisare well known to those skilled in the art, and processes such as areknown for ligands can be used. Thus for example a binding site forpolyethylene glycol, to which the PEG is bound after transcription, canbe provided in a small part of the modified nucleotides used for themRNA according to the invention. The polyethylene glycol serves for theextracellular stabilization of the mRNA, i.e. it protects thepolyribonucleotide molecule until it has arrived in the cell. On entryinto the cell, the PEG is cleaved off. Hence the bond between PEG andRNA is preferably designed such that the cleavage on entry into the cellis facilitated. For this, for example a functional group can be providedwhich is pH-dependently cleaved off. Other molecules stabilizing the RNAcan also be provided via appropriate active sites on the modifiednucleotides. In this way, the mRNA can be protected by stericstabilization against enzymatic degradation and an interaction withcomponents of biofluids prevented. The mRNA thus modified can bedesignated as “stealth” mRNA.

A preferred method for the protection and stabilization of RNA isdescribed in EP 11 98 489, to the content whereof reference is expresslymade here. RNA according to the invention is preferably protected by themethods described in EP 11 98 489. It has been found that firstly theRNA modified according to the invention can also advantageously bestabilized and protected by this method and secondly that the activityof RNA according to the invention thus treated is not or notsignificantly restricted. Hence in a preferred embodiment of the presentinvention, RNA modified according to the invention is treated inaccordance with EP 11 98 489.

An example of cell-specific regulation is the incorporation of micro-RNAbinding sites for micro-RNA 142-3p, which is expressed in hematopoieticcells, but not in cells of other origin. As a result, the expression iscontrolled such that the mRNA translation in hematopoietic cells ismarkedly diminished compared to other cells. Similarly, the expressionin other cell types can be selectively controlled by incorporation ofthe relevant suitable micro-RNA binding sites, which are known to thoseskilled in the art.

In a further embodiment, the mRNA according to the invention is combinedwith a target or a binding site for at least one micro-RNA which ispresent only in healthy cells, but not the cells affected by thedisease. As a result, the protein encoded by the mRNA is produced onlyin the cells which need the protein. The selection of the suitabletargets is made by routine methods which are well known to those skilledin the art. A common method which is performed at the DNA level is thecloning of a micro-RNA binding site into 3′UTR (Gu et al, Nat Struct MolBiol. 2009 February; 16(2): 144-50, Brown et al, Nat Biotechnol. 2007December; 25(12): 1457-67, Brown et al, Nat Med. 2006 May; 12(5):585-91, WO 2007000668). In a preferred embodiment, an RNA equipped witha binding site for micro-RNA is used when the RNA encodes a cytotoxin.In this case it is especially desirable to bring the protein toxic tocells only where it is intended to deploy its action. For thisembodiment, it can also be advantageous to adjust the duration of actionof the RNA by specifically modifying the RNA so that its stability liesin a predefined time window.

Further, the RNA according to the invention can be combined withmicro-RNAs or shRNAs downstream of the 3′ polyA tail. This has theadvantage that the mRNA-micro-RNA/shRNA hybrid can be cleavedintracellularly by Dicer and thereby two active molecules whichintervene in different pathogenic cascades can be released. Such ahybrid can be provided for the treatment of diseases such as cancer orasthma. Hence the RNA according to the invention is suitable forsimultaneously complementing a deficient mRNA and intervening in adefective micro-RNA cascade.

Thus according to the invention, an RNA with advantageous properties isprovided which can be tested with a screening method wherein a sequencecoding for a reporter protein, e.g. red fluorescing protein (RFP), isused. When the toxicity and stability of sequences of a reporter genewith unmodified, singly or multiply modified nucleotides with differentmodifications are tested for their immunogenicity and transfectionefficiency, it is found that only the mRNA according to the invention,i.e. modified multiply, wherein at least 5% respectively of the uridinenucleosides and cytidine nucleosides are replaced by modifiednucleosides leads to a markedly reduced immunogenicity towards humanprimary monocytes in the blood and at the same time can yield hightransfection rates of more than 80%. This can for example be tested inalveolar epithelial cells type II in humans or in the mouse. Moreover,the duration of the RNA expression for RNAs modified according to theinvention is significantly longer than with known RNA. It has been foundthat mainly owing to the higher stability and lower immunogenicity ofthe mRNA multiply modified according to the invention the expressionlasts longer than with known preparations. In a quantitative assessment,a derivative modified according to the invention showed a 10 timeshigher quantity of expression product 10 days after the transfectionthan non- or only singly modified RNA.

A further subject of the invention is a method for the screening ofnucleotide sequences in order to test the immunogenicity and expressionquality, wherein the mRNA sequence is contacted with at least onereceptor selected from TLR3, TLR3, TLR8 and helicase RIG-1 and thebinding capacity measured in comparison with a control sequence. As thecontrol sequence, a sequence is used the binding capacity whereof isknown. The weaker the binding to at least one of these receptors is, themore promising is the sequence.

The properties of mRNA according to the invention, in particular IVTmRNA, can be tested with a screening method on an RNA expressing areporter protein. The red fluorescing protein (RFP) is preferred as thereporter protein. Sequences encoding this protein which have nucleotideswith different modifications can be tested for their immunogenicity andtransfection efficiency. Thus various modifications of mRNA can be usedfor tests, e.g. uridine nucleosides can be partially replaced by2-thiouridine nucleosides (also referred to below as s2U) and cytidinenucleosides can be partially replaced by 5-methylcytidine nucleosides(also referred to below as m5C).

FIGS. 1A, 1B, 1C, 2A and 2B show the results which are obtained onperforming such a screening method. More detailed particulars are to befound in the examples. The results shown in the figures are based onexperiments which were performed for RFP RNA and show that only multiplymodified mRNA wherein at least 5% of the uridine nucleosides and atleast 5% of the cytidine nucleosides respectively are modified lead tomarkedly reduced immunogenicity towards human primary monocytes in theblood, both ex vivo and in vivo, and at the same time can yield hightransfection rates of more than 80% both in alveolar epithelial cellstype II in humans and also in the mouse. Moreover, the duration of theexpression for mRNAs modified according to the invention issignificantly longer than for unmodified mRNA.

In a further embodiment, a method is provided for testing whether an RNAunder consideration is suitable for therapy, with the use of an mRNAimmunoprecipitation test (RIP). A suitable RIP test is described in moredetail in the examples. Studies have shown that cells of the immunesystem are activated by unmodified reporter mRNA via RNA binding toToll-like receptor (TLR) 3, TLR7, TLR8 and helicase RIG-1. When theresults show that the binding of a tested mRNA to TLR3, TLR7, TLR8and/or RIG-1 is markedly decreased compared to unmodified mRNA this isan indication of decreased immunogenicity. It could be shown that inthis respect multiple modifications used according to the invention aresignificantly more effective than single s2U modifications. In theexamples, the influence of RNA on the level of IFN-γ, IL-12 and IFN-αwas studied, after the RNA had been injected intravenously into mice. Itwas found that multiply modified s2U_((0.25))m5C_((0.25)) RFP mRNAprevented an immune response. The results obtained in the examplestogether show that multiply modified mRNA significantly decreases theTLR and RIG-1 binding and hence lowers the immune response with at thesame time elevated and prolonged expression. Hence a multiply modifiedRNA, in particular IVT mRNA, is a suitable candidate for the in vivotreatment of a disease due to a deficient gene. A particularly promisingcandidate is briefly explained below and described in more detail in theexamples.

In order to test whether it is possible to use RNA modified according tothe invention for treatment in the lung, multiply modified mRNA whichcodes for a fusion protein of enhanced green fluorescent protein andluciferase (EGFPLuc) was introduced directly into the lung of a mouseand tested as to whether luciferase was expressed in comparison withunmodified EGFPLuc RNA. The luciferase expression reached a maximumafter three hours in the lung, although the total luminescent fluxrapidly declined after 24 hours to very low proportions 5 days after thetreatment. In contrast to this, high expression values were observed upto 5 days after the treatment in mice which had been treated withmultiply modified EGFPLuc mRNA.

In a particularly preferred embodiment, an RNA is provided whosetherapeutic potential allows treatment of the disease attributable toSP-B deficiency, namely s2U_((0.25))m5C_((0.25)) SP-B mRNA. SP-B is arelatively small amphipathic peptide which is encoded by a single geneand through proteolytic processing creates a precursor with 381 aminoacids in type II alveolar epithelial cells which coat the alveoli. Itimproves the distribution, adsorption and stability of the surfactantlipids which are necessary for the reduction of the surface tension inthe alveoli. With a deficiency of SP-B, symptoms such as thickenedalveolar walls, cellular infiltration and interstitial edema occur. Thislung damage is accompanied by congestion, i.e. an increased number oferythrocytes and an increased number of macrophages, neutrophils andcorresponding proportions of inflammatory cytokines in thebroncho-alveolar fluid. The congenital deficiency in humans and studieson transgenic mice have proved that SP-B plays an essential role insurvival after birth. Congenital SP-B deficiency, which arises throughmutations in the SP-B gene, is critical for the replacement of thesurfactant and leads to a fatal failure of the respiratory tract in thenewborn during the first months of life. Hence a lung transplant is theonly currently available therapeutic intervention. Hence an mRNA therapyfor SP-B deficiency, which is rendered possible with the RNA accordingto the invention, is an important alternative treatment.

The RNA according to the invention can be used for the treatment of thisdisease, preferably with perfluorocarbon as vehicle. Hence in apreferred embodiment a pharmaceutical preparation comprisingperfluorocarbon and s2U_((0.25))m5C_((0.25)) SP-B mRNA is provided. Thiscombination makes it possible to reconstitute SP-B in the lung ofpatients with SP-B deficiency, so that the chances of survival areincreased. Because of the high stability of the RNA according to theinvention, administration at regular intervals, e.g. 1 to 3 times weeklyis sufficient for this. Preferably the SP-B mRNA is administered forthis intratracheally as an aerosol by spraying at high pressure. It hasbeen found that the mRNA according to the invention can ameliorate thesymptoms described above and thus improve the lung function, which canbe demonstrated by testing of the lung parameters, as described indetail in the examples.

The mRNA according to the invention can be effectively used intherapeutic procedures and makes a treatment of diseases due to missingor defective proteins possible. Systemic administration of the multiplymodified mRNA is possible. There can be cases wherein the mRNAtranslation in cells which are not affected by the gene defect isundesirable, e.g. because undesired side effects arise. In order to havethe mRNA translated selectively only in the cells which need the encodedprotein, e.g. in cells in which a gene defect exists, the correspondingvector can either be supplemented by sequences which enable addressingof the tissue affected, e.g. via ligands. In a further embodiment,sequences to which endogenous micro-RNAs bind, which are not expressedin the target cell, can be added to the vector which contains the mRNA,so that the mRNA are degraded in all cells which contain the relevantendogenous micro-RNAs, while they are retained in the target cells. Thusside effects can be minimized.

The RNA according to the invention can be administered in a manner knownper se to patients who need the protein or protein fragment encoded byRNA, e.g. because they have a disease due to a deficient gene. For this,the RNA is formulated as a pharmaceutical preparation with normalpharmaceutically acceptable additives. The form of the preparationdepends on the location and the nature of administration. Since the RNAaccording to the invention is characterized by particularly highstability, it can be formulated in many ways, depending on where and inwhat form it is to be used. It has been found that the RNA according tothe invention is so stable that it can be freeze-dried, processed inthis form, e.g. crushed or milled, and stored, and can then bereconstituted when required and retains its biological activity.

When the RNA is administered systemically, it is usually formulated asan injectable liquid with normal additives such as agents adjusting thetonicity and stabilizers, preferably as a unit dosage form. Asstabilizers, those normally known, such as for example lipids, polymersand nanosystems or liposomes, are used. In a preferred embodiment, acomposition suitable for parenteral administration is provided whichcontains RNA modified according to the invention which encodes EPO.

In a preferred embodiment, particularly when the RNA encodes SP-Bprotein, the RNA according to the invention is provided in a formsuitable for uptake via the lung, e.g. by inhalation. Suitable formulaefor this are known to those skilled in the art. In this case thepreparation is in a form which can be introduced into the respiratorytract via normal nebulizers or inhalers, e.g. as a liquid for nebulizingor as a powder. Devices for administration as liquid are known, andultrasound nebulizers or nebulizers with a perforated oscillatingmembrane which operate with low shear forces compared to nozzle jetnebulizers are suitable. Also suitable are powder aerosols. Both mRNAcomplexed with cationic lipids and also bare mRNA is available after thefreeze-drying with the sugar sucrose as powder that can then be crushedto a respirable size and moreover shows biological activity.

In a preferred embodiment, a pharmaceutical composition intended forpulmonary administration is combined with perfluorocarbon, which isadministered previously or simultaneously with the pharmaceuticalcomposition in order to increase the transfection efficiency.

In a further preferred embodiment, RNA modified according to theinvention is provided in a delayed release polymer as a carrier for thecoating of implants. For this the RNA modified according to theinvention can be used as such or else an RNA protected with a coatingpolymer and/or polymer complex.

A further subject of the invention are implants on the surface whereofthere is a coating of a delayed release polymer which contains RNA whichencodes beneficial factors for the ingrowth of the implant. According tothe invention both coatings which contain mRNA which encodes only onefactor and also coatings which contain mRNAs which encode severalfactors, e.g. various growth factors or growth factors and angiogenesisfactors or further factors promoting ingrowth, are possible here. Thevarious factors can also be provided in a form such that they arereleased at staggered intervals.

Furthermore, the expression “RNA which encodes one or more growthfactors and one or more angiogenesis factors” should be understood tomean both an RNA sequence which encodes more than one protein, singly oras a fusion protein, and also a mixture of different RNA sequences whichencode different proteins, where each RNA sequence encodes one protein.

The invention is further explained by the following examples.

EXAMPLE 1

In order to be able to assess the therapeutic utility of an IVT mRNA, itwas assessed whether non-immunogenic IVT mRNA could be obtained for invivo use. Hence in a first step, in vitro transcribed mRNA for redfluorescing protein (RFP) with modified nucleosides was investigatedwith regard to immunogenicity and transfection efficiency. The resultsshow that multiply modified mRNA wherein 25% of the uridine is replacedby 2-thiouridine (s2U) and 25% of the cytidine by 5-methylcytidine (m5C)yields s2U_((0.25))m5C_((0.25)) IVT mRNA which has markedly reducedimmunogenicity towards human primary mononuclear blood cells, as shownin FIG. 1A, and a high transfection rate of more than 80% in epithelialcells of the alveolar type II both in humans (FIG. 1B) and also in themouse (FIG. 1C). Moreover, the duration of the mRNA expression wassignificantly prolonged (FIG. 2A). The results show that this prolongedexpression is mainly due to the higher stability of the mRNA multiplymodified according to the invention. An absolute quantitative assessmentshowed an approximately 10 times greater quantity ofs2U_((0.25))m5C_((0.25)) RFP mRNA 7 days after the transfection (FIG.2B). The translation efficiency was somewhat diminished for the modifiedRFP mRNA and hence could not contribute to higher and longer activity(FIG. 4).

In the next step, the mechanism on which the reduced immune response isbased was investigated using a modified RNA immunoprecipitation test(RIP assay). Studies have shown that cells of the immune system areactivated by unmodified reporter mRNA (1) by RNA binding to Toll-likereceptor (TLR) 3 (2), TLR7 (3), TLR8 (4) and helicase RIG-1 (5). Theresults show that the binding of the multiply modified RFP mRNAaccording to the invention to TLR3, TLR7, TLR8 and RIG-1 was markedlyreduced compared to unmodified RFP mRNA. In this respect, the multiplemodifications were considerably more effective than a single s2Umodification (FIG. 2C). As was to be expected from the binding studies,unmodified RFP mRNA increased IFN-γ, IL-12 and IFN-α to a considerableextent when it was injected intravenously into mice, while multiplymodified s2U_((0.25))m5C_((0.25)) RFP mRNA prevented an immune response(FIG. 2D). Overall, these results show that the mRNA multiply modifiedaccording to the invention markedly decreased the TLR and RIG-1 bindingand thereby the immune response, and at the same time increased andprolonged expression, which makes such mRNA a very promising candidatefor in vivo tests.

It was therefore tested whether an s2U_((0.25))m5C_((0.25)) mRNA whichencoded a fusion protein of enhanced green fluorescent protein andluciferase (EGFPLuc) which was introduced directly into the lungs of themouse could intensify and prolong the luciferase expression in vivo incomparison to unmodified EGFPLuc mRNA. For this purpose, a high pressurespray device for intratracheal administration known per se as describedfor example in (6) was used, perfluorocarbon (fluorinated FC-77) beingadministered beforehand in order to increase the transfection efficiency(7). After 3 hours the luciferase expression reached a maximum in thelungs in vivo, although the total luminescence rapidly decreased after24 hours to a low level 5 days after the treatment (FIGS. 3A and B). Incontrast to this, high expression values were observed up to the 5^(th)day after the treatment in mice which were treated withs2U_((0.25))m5C_((0.25)) EGFPLuc mRNA (FIGS. 3A and B).

This shows that the therapeutic potential of the multiply modified mRNAaccording to the invention for therapy is very promising. Hence ans2U_((0.25))m5C_((0.25)) SP-B mRNA multiply modified according to theinvention was tested for the treatment of SP-B deficient mice. SP-B is arelatively small amphipathic peptide which is encoded by a single geneand in epithelial cells of the alveolar type II is converted byproteolytic processing into a precursor with 381 amino acids which coatsthe alveoli (8, 9). It improves the distribution, adsorption andstability of the surface-active lipids which are necessary for thereduction of the surface tension in the alveolus. If the gene for thisprotein is deficient, disorders in the respiratory tract occur afterbirth which can rapidly lead to death. It has been observed that ahereditary defect in humans and in transgenic mice plays an importantpart in postmortal survival (10). A hereditary SP-B deficiency whicharises through mutations in the SP-B gene prevents the formation of thesurface-active lipids, which leads to respiratory failure during thefirst months after birth (11). A lung transplant is the only therapeuticintervention that is currently possible (12). Hence an mRNA therapy forSP-B deficiency would be an alternative treatment to ensure viabilitywith this deficiency.

Hence a knockout mouse model for SP-B deficiency was selected in orderto test a gene therapy with multiply modified mRNA of SP-B according tothe invention. For this a mouse model was chosen wherein the mouse SP-BcDNA was expressed under the control of exogenous doxycycline inSP-B^(−/−) knockout mice. Withdrawal of doxycycline in adult SP-B^(−/−)mice resulted in a decreased content of SP-B in the lung, which resultedin respiratory failure when the SP-B concentration fell below 25% of thenormal level. Conditioned transgenic mice which received doxycyclinesurvived normally (13, 14). The therapeutic strategy used comprised thefollowing: (i) pre-treatment of the mice with perfluorocarbon before theintroduction of SP-B mRNA, in order to increase expression and (ii)repeated use of SP-B mRNA twice weekly every third or fourth day forfour weeks (FIG. 3C). In order to perform an experiment to demonstratethis principle, s2U_((0.25))m5C_((0.25)) SP-B mRNA was administeredintratracheally as an aerosol into conditional SP-B^(−/−) mice using ahigh pressure nebulizer. This treatment saved the mice from respiratoryfailure and extended their average lifespan to 28.8±1.1 days (FIG. 3D),up to the defined endpoint of the study. In contrast to this, afterwithdrawal of the doxycycline, untreated SP-B^(−/−) mice displayedsymptoms of an acute respiratory problem within 3 to 4 days. This wasalso observed after administration of perfluorocarbon alone orperfluorocarbon with s2U_((0.25))m5C_((0.25)) EGFPLuc mRNA as a control,the mice then dying within 3.8±0.4 days (FIG. 3D, and data not shown).Moreover, successful reconstitution of SP-B in the lungs of the micetreated with s2U_((0.25))m5C_((0.25)) SP-B mRNA was confirmed byimmunostaining (FIG. 3E) and semiquantitative Western blot analysis(FIG. 3F) for SP-B. The pulmonary histology was normal in mice which hadbeen treated for 4 weeks with s2U_((0.25))m5C_((0.25)) SP-B mRNA, whilethe lungs of the mice which had received s2U_((0.25))m5C_((0.25))EGFPLuc control mRNA displayed thickened alveolar walls, cellularinfiltration and interstitial edema after 4 days (FIG. 3G). This lungdamage was accompanied by congestion (elevated number of erythrocytes)and an elevated number of macrophages and neutrophils and an elevatedlevel of inflammatory cytokines (FIG. 3H and FIG. S4) in thebronchoalveolar lavage fluid (HALF), while this was largely prevented inthe mice treated with SP-B mRNA. It has been shown that the withdrawalof doxycycline worsened pulmonary function without treatment (14, 15).It has been observed that prolonged treatment of SP-B^(−/−) mice withs2U_((0.25))m5C_((0.25)) SP-B mRNA maintained the normal pulmonaryfunction, as in the SP-B^(−/−) mice which received doxycycline (FIG. 3Iand FIG. S5).

To summarize, these results show that all functional and pathologicalparameters of the SP-B deficiency in the lung improved substantially andwere comparable with conditional SP-B^(−/−) mice which receiveddoxycycline.

The results show the therapeutic efficacy of the multiply modified mRNAin a mouse model for a lethal lung disease. However, the furtherapplication of the mRNA therapy can still be improved as follows: (i)undesired mRNA translation in cells of unaffected tissue could lead toundesired effects outside the target region, (ii) if the multiplymodified mRNA also reaches unaffected tissue, an adequate quantity ofmRNA must be provided and (iii) repeated dosing is necessary forshort-duration mRNA activity. In order to improve this, micro-RNAbiology can be enlisted in order to prevent undesired mRNA translationin cells not affected by the disease. By incorporating target sequencesof endogenous micro-RNAs, which are not expressed in the target cell,mRNA degradation can be selectively caused in cells not affected by thedisease, during which however the mRNA is retained in the target cells,as a result of which side effects are minimized (16, 17).

In a further approach, release systems, the targeting ligands, whichbind specific receptors to cell surfaces, can be combined, so thatreceptor-mediated transfection of the target cell is enabled. Since mRNAcan be produced in large quantities nowadays (18) and efficientproduction processes for the production even of multiply modified mRNAon a large scale are possible, the clinical use of the mRNA according tothe invention is possible and this makes it possible to develop mRNAsystems specifically tailor-made for each disease (19, 20), whereby thedosing frequency and the short-duration activity can be kept to aminimum, which is not possible with the currently known therapies. Inthis way, according to the invention an effective molecular therapy forthe treatment of disease due to a gene deficiency is provided.

EXAMPLE 2

In order to show that in SP-B deficient mice an improvement in conditionor an increase in life expectancy is achieved merely by the use of themRNA modified according to the invention which encodes SP-B, a furtherexperiment was performed. The mouse model and conditions as described inexample 1 were used.

Three groups of mice were set up. One group of SP-B deficient micereceived mRNA modified according to the invention twice in one week (B),a second group received mRNA modified according to the invention twice aweek for 28 days (C), and for comparison a third group of mice receivedmodified EGFP-Luc mRNA (A).

It was found that the mice which received no SPB mRNA modified accordingto the invention died after a short time. The mice which received theRNA according to the invention survived only as long as they were giventhe SP-B RNA according to the invention. This proves that the RNAaccording to the invention is biologically active and can replacenecessary protein.

In detail, the experiment was performed as follows. SP-B KO mice, asdescribed in example 1, received either modified EGFP-Luc mRNA (A)(n=10) or modified SP-B mRNA twice in one week (B) (n=4) or modifiedSP-B mRNA twice a week for 28 days (C) (n=4). Kaplan-Meier survivalcurves were plotted and a Wilcoxon-Gehan test performed. It was foundthat the intratracheal administration of the doubly modified SP-B mRNAtwice within one week into the lungs of transgenic SP-B mice (B) inwhich the SP-B gene is controlled by the addition of doxycycline in thedrinking water prolongs the average survival time of the mice afterwithdrawal of the doxycycline from the drinking water before the startof the treatment to 10.2±0.5 days (B) in comparison to 3.4±0.2 daysafter administration of an EGFP-Luc control mRNA.

The results are presented in the diagram of FIG. 12. It is found thatthe intratracheal administration of the doubly modified SP-B mRNAaccording to the invention is in fact life-saving. Without addition ofthe mRNA according to the invention, the mice die after a short time.This experiment also shows firstly that SP-B mRNA produces the SP-Bnecessary to life in vivo and secondly that the SP-B mRNA must beadministered continuously to protect the experimental animals fromdeath.

EXAMPLE 3

In a further experiment in which the mice described in example 1, whichall received doxycycline, were used, it was investigated whether the RNAaccording to the invention causes inflammatory reactions in an earlyphase after administration. For this, 5 groups were set up and cytokinelevels, IFNγ and IL-12 were measured in the bronchoalveolar lavage ofmice 8 hours after administration of different preparations. The sixgroups received the following preparations: a) control, untreated, i.e.neither perfluorocarbon nor RNA, b) control, perfluorocarbon, c)control, perfluorocarbon and unmodified SP-B mRNA, d) invention,perfluorocarbon and modified s2U_((0.25))m5C_((0.25)) SP-B mRNA and e)control, perfluorocarbon and SP-B plasmid DNA, (n=4). In each case 20 μg(50 μl) of a preparation were administered. The results are shown inFIG. 13. In FIG. 13, the mean value±standard error is shown. Thefollowing abbreviations were used in FIG. 13: Doxy—doxycycline,Pfc—perfluorocarbon, pDNA—plasmid DNA (*P<0.05 compared with theuntreated group).

The results show that on intratracheal administration of unmodified mRNAor plasmid DNA the inflammatory marker IL-12 is markedly elevated in thebronchoalveolar lavage, while the administration of doubly modified mRNAleads to no rise in IL-12 in comparison to untreated mice. Theadministration of doubly modified mRNA does slightly increase the levelof the inflammatory marker IFNγ, but only as far as is also observedafter administration of perfluorocarbon. In contrast to this, theadministration of unmodified mRNA or the administration of plasmid DNAalso leads to a marked rise in the IFNγ level. Thus using the mRNAmodified according to the invention an inflammatory reaction is not tobe expected, while the administration of unmodified mRNA or even plasmidDNA very rapidly causes inflammatory reactions.

EXAMPLE 4

In order to demonstrate the possibilities for use of the mRNA modifiedaccording to the invention, various types of modifications and theireffect on the transfection and translation efficiency and onimmunogenicity were studied. A459 cells were transfected with 200 ng ofmRNA in each case and how many of the cells had been transfected and inhow many cells the fluorescent protein had been translated was theninvestigated. This evaluation was made using the mean fluorescenceintensity (MFI). The results are shown in FIG. 10A. mRNA modifiedaccording to the invention was tested and in comparison to this an mRNAmodified not according to the invention, in which two differentmodifications of uridine nucleotides were used and non-modified mRNA.The mRNA molecules modified according to the invention were:

s2U/m5C and s4U/m5C wherein the modified nucleotides each had a contentof 10% and RNA molecules which in addition to 10%/10% s2U/m5C ands2U/5mC each contained a further 5% of modified nucleotides, namely onceC₂′NH₂ and once 5% G′N₃. The results show that the mRNA modifiedaccording to the invention displays a very high transfection efficiency,while unmodified mRNA and mRNA modified not according to the inventioneach show far lower transfection and translation efficiency.

The immunogenicity was also tested for the modified mRNA previouslydescribed, by investigating the TNF-α level on human PBMCs afteradministration of 5 μg of each mRNA. The results are shown in FIG. 10B.As is clearly seen, the TNF-α level is markedly elevated onadministration of unmodified mRNA or with mRNA wherein two types ofmodified uridine nucleotides were used. The TNF-α level is lower by atleast 50% with the RNAs modified according to the invention than withunmodified RNA.

EXAMPLE 5 Method for the Production of Multiply Modified mRNA Accordingto the Invention

a) Constructs for the In Vitro Transcription

For the in vitro transcription of RFP cDNA (678 bp), a plasmid,pCS2+DsRedT4, containing an SP6 promoter was used. For the in vitrotranscription of SP-B cDNA (1146 bp), a pVAX1 plasmid (Invitrogen)containing a T7 promoter was used. In order to create the vector for thein vitro transcription of EGFPLuc (2.4 kb), a pST1-2β-globin-UTR-A-(120)construct containing a T7 promoter which was obtained as described in(19) was used. The constructs were cloned using standard techniques ofmolecular biology.

Production of Modified mRNA

In order to create templates for the in vitro transcription, thepCS2+DsRed.T4, EGFPLuc and SP-B plasmids were linearized with XbaI. Thelinearized vector DNAs were purified with the NucleoSpin Extract II kit(Macherey-Nagel) and assessed by spectrophotometry. The in vitrotranscription was performed with the mMESSAGE-mMACHINE SP6 or T7Ultrakit (Ambion). The SP-6 kit capped the mRNA with 7-methylGpppG,while the T7 kit created the analogous antireverse cap (ARCA;7-methyl-(3′-O-methyl)GpppGm⁷G(5′)ppp(5′)G in a transcription reactionwith ultrahigh yield. In order to produce RNA modifications, thefollowing modified ribonucleic acid triphosphates were added to thereaction system in the stated ratios: 2′-thiouridine 5′-triphosphate,5′-methylcytidine 5′-triphosphate, pseudouridine 5′-triphosphate andN⁶-methyladenosine 5′-triphosphate (all from TriLink BioTechnologies andchecked for purity with HPLC and ³¹P NMR). After the in vitrotranscription, the RNA from the pVAX1 SP-B plasmid was enzymaticallypolyadenylated using the poly(A) tail kit (Ambion). The poly(A) tailswere approximately 200 nt long. All capped mRNAs (RFP, EGFPLuc and SP-B)were purified using the MEGAclear kit (Ambion) and analyzed for size andpurity with the Agilent RNA 6000 Nano Assay on a Bioanalysis Instrument2100 (Agilent Technologies).

Cell Transfections

Lung Cell Transfection

Type II alveolar epithelial cell lines from humans and from the mouse,A549 and MLE12 respectively, were grown in Minimal Essential Medium(Invitrogen) which was supplemented with 10% fetal calf serum (FCS), 1%penicillin-streptomycin and 0.5% gentamycin. One day before thetransfection, 80 000 cells per well were plated out in 24-well plates.The cells (more than 90% confluence) were transfected with 200 ng ofmRNA with the use of Lipofectamin 2000 (Invitrogen) according to themanufacturer's instructions. After 4 hours, the cells were washed withPBS and serum-containing medium was added. For analyses of long-termexpression, the cells were regularly subdivided (when the confluence was>90%).

Human PBMC Transfection

Human PBMCs (CTL-Europe GmbH) cryoconserved in liquid nitrogen werecarefully thawed at 37° C. using CTL Anti-Aggregate Wash Supplement,during which sterile-filtered RPMI-1640 (Invitrogen) was slowly added.For all experiments described, a single characterized batch of PBMCs wasused in order to make the data reproducible.

Flow Cytometry

A flow cytometry analysis was performed on the A549 and MLE12 cellswhich had been transfected with RFP mRNA, as described above. The cellswere removed from the plate surface with 0.25% trypsin/EDTA, washedthree times with PBS and again suspended in PBS in order to measure thefluorescence using an FACSCalibur (BD Biosciences). The transfectionefficiency was calculated from the percentage of the cell populationwhich exceeded the fluorescence intensity of the control cells, whichhad only been treated with PBS. At least 2500 cells per tube werecounted. The data were analyzed with Cellquest Pro.

Cytokine Detection

Enzyme-linked immunosorbent assays (ELISA) were performed using humanIL-8 and TNF-α kits (RayBio), mouse IFN-γ and IL-12 (P40/P70) kits(RayBio) and mouse IFN-α kit (RnD Systems).

Real Time In Vitro Translation

500 ng of RFP mRNA was in vitro translated using Retic Lysate IVT(Ambion). Methionine was added to a final concentration of 50 μM. Themixture was incubated at 30° C. in a water-bath, samples were withdrawnat various times and the fluorescence intensity at 590 nm measured on aWallac Victor² 1420 Multilabel Counter (Perkin Elmer).

Quantitative RT-PCR

The total RNA was extracted from A549 cells with RNeasy Minikit (Qiagen)or from human PBMCs (see RIP protocol below) and subjected to a reversetranscription (RT) in a batch of 20 μl using the iScript cDNA synthesiskit (Bio-Rad) in accordance with the product manual. cDNA was amplifiedusing the iQ SYBR Green Supermix and iCycler (Bio-Rad) in double batcheswith the following primers: RFP: 5′-GCACCCAGACCGCCAAGC (forwards) andRFP: 5′-ATCTCGCCCTTCAGCACGC (backwards). C_(t) values were obtainedusing the iCycler IQ software 3.1 (Bio-Rad) which automaticallycalculated the baseline cycles and threshold values.

RNA Immunoprecipitation (RIP)

1×10⁶ human PBMCs (CTL-Europe GmbH) were transfected with 5 μg of mRNAusing 12.8 μl of Lipofectamin 2000 in 1 ml of OptiMEM 1. After 4 hours,the media were supplemented with 10% FCS. After 24 hours, the cellsuspension was transferred into tubes and the cells were pelletized by10 minute centrifugation at 350 rpm. Next a modified version of theChIP-IT Express protocol (ActiveMotive) was used in order to perform theRIP. DEPC-treated water (Serva Electrophoresis) was used for thepreparation of all necessary reagents. In accordance with the ChIP-ITmanual, the fixing solution and then the glycine stop-fix solution andice-cold 1×PBS were added to the cells and the cells were pelletized at4° C. Then the cells were again suspended in lysis buffer to which theprotease inhibitors PIC and PMSF had been added, and incubated for 30mins on ice. After 10 minute centrifugation at 2400 rpm at 4° C., thesupernatant was subjected to the capture reaction. The TLR-mRNA/RIG-mRNAcomplexes were captured overnight on magnetic beads in 8-well PCRstrips, as described in the ChIP-IT Express manual. In addition,SUPERase RNase inhibitor (Applied Biosystems/Ambion) was added to afinal concentration of 1 U/μl. Anti-human TLR3 mouse IgG1, TLR7 rabbitIgG1, TLR8 mouse IgG1 (all from Imgenex) and RIG-1 rabbit IgG1 (ProSciIncorporated) were used as antibodies. After the washing of the magneticbeads, the TLR-mRNA/RIG-mRNA antibody complexes were eluted, reversecrosslinked and treated with proteinase K in accordance with the ChIP-ITExpress protocol. Finally, the eluted mRNA was subjected to a reversetranscription and a quantitative RT-PCR, as described above.

In Vivo Bioluminescence

D-luciferin substrate was dissolved in water, the pH adjusted to 7 andthe final volume adjusted such that a concentration of 30 mg/ml wasreached. 50 μl of this solution were applied onto the nostrils of theanesthetized mice and absorbed by snuffling (1.5 mg luciferin/mouse).After 10 mins, the bioluminescence was measured with an IVIS100 imagingsystem (Xenogen) as described in (21) using the following camerasettings: visual field 10, f1 f-stop, high resolution and illuminationtimes from 1 to 10 mins. The signal in the pulmonary region wasquantitatively assessed and analyzed, the background being subtractedusing the Living Image Software Version 2.50 (Xenogen).

Animal Studies

6 to 8 week old female BALB/C mice (Charles River Laboratories) werekept under specific pathogen-free conditions and kept in individuallyventilated cages with a 12-hour light: 12-hour dark cycle and suppliedwith food and water ad libitum. The animals were acclimatized for atleast 7 days before the start of the experiments. All animalmanipulations were approved and were checked by the local ethicalcommittee and performed according to the guidelines of the German AnimalProtection Law. For all experiments except for the injection into thecaudal vein, the animals were anesthetized i.p. with a mixture ofmedetomidine (0.5 mg/kg), midazolam (5 mg/kg) and fentanyl (50 μg/kg).After each experiment, an antidote which consisted of atipamezol (50μg/kg), flumazenil (10 μg/kg) and naloxone (24 μg/kg) was administeredto the animals s.c. Blood for the ELISA tests was obtained at varioustimes by puncture of the retrobulbar vein using heparinized 1.3 mmcapillaries (Marienfeld).

Injection into the Caudal Vein

25 μg of RFP mRNA were mixed in vivo with Megafectin (MP BiomedicalsEurope) in a ratio of mRNA to lipid of 0.25 and Enhancer-3 was added inaccordance with the manufacturer's recommendation. The integrity andparticle size of the injected complexes was determined with dynamiclight scattering (DLS) using a Zeta-PALS/zeta potential analyzer(Brookhaven Instruments Corp.). The mice were laid in a restrainer and100 μl of the mRNA/Megafectin solution (equivalent to 5 μg of mRNA) wereinjected into the caudal vein within 30 seconds using a 27 gauge needleand a 1 ml syringe.

Intratracheal Administration by High Pressure Nebulization

BALB/c and SP-B^(−/−) mice were anesthetized as described in (14) andimmobilized on a plate system (Halowell EMC) such that the upper teethwere at an angle of 45°. A modified cold light otoscope Beta 200 (HeineOptotechnik) was used in order to optimally illuminate the pharynx. Thelower jaw of the mouse was opened with a small spatula and blunt forcepswere used to push the tongue aside and maximally expose the oropharynx.A model 1A-1C microsprayer which was connected to a model FMJ-250 highpressure syringe (both from PennCentury Inc.) was insertedendotracheally and 25 μl of Fluorinert FC-(Sigma) and 25 μl ofluciferase mRNA solution (10 μg) or 50 μl of SP-B mRNA solution (20 μg)were successively applied. After 5 secs the microsprayer syringe waswithdrawn and the mouse was taken from the support after 5 mins.

Pulmonary Function Measurements

Homozygotic SP-B^(−/−) mice±doxycycline±modified mRNA were anesthetizedas described above. To prevent spontaneous breathing, vecuronium bromide(0.1 mg/kg) was injected intraperitoneally. The pulmonary mechanicalmeasurements were performed as described in (22). In brief, a bluntsteel cannula (external diameter 1 mm) was inserted in the trachea withtracheostomy. The piston pump respirator served both as respirator andalso as a measurement device (flexiVent, SAV). During the tidalventilation, the respirator was set to controlled volume- andpressure-restricted ventilation (Vt=10 μl/g, Pmax=30 cm H₂O, PEEP 2-3 cmH₂O at 2.5 Hz and 100% oxygen). The Vt used was 8.4±1.4 μl/g in animalswhich were receiving doxycycline and 8.9±0.4 μl/g BW in animals whichwere receiving doxycycline and mRNA (N.S.). The dynamic-mechanicalproperties of the respiratory system and also the pulmonary entryimpedance were measured at 5 minute intervals in animals afterinsufflation twice at 15 μl/g for 1 sec in order to create a standardvolume history. For the oscillatory measurement, the ventilation wasstopped at the PEEP level. In order to determine the impedance of therespiratory system (Z_(rs)) by forced oscillations (FOT), whichconsisted of a pseudorandom oscillatory signal of 8 secs, an amplitudeof 3 ml/g was used. The forced signal had frequencies between 1.75 and19.6 Hz (23, 24). The data were collected at 256 Hz and analyzed with awindow of 4 secs with 66% overlap. The pulmonary impedance data wererepresented as resistance (real part) and reactivity (imaginary part) ofthe respiratory system within the frequency domain. The pulmonaryimpedance data (Zrs) were subdivided using the constant phase model ofthe lung, as proposed by Hantos et al. (25). In this model, Zrs consistsof a respiratory resistance (Rn), a respiratory tract inertia (inertia),a tissue elasticity (H_(L)) and a tissue damping (G_(L)) according tothe equation:

Zrs=Raw+jωlaw+(G _(L) −jH _(L))/ω^(α),

wherein ω is the angular frequency and ω the frequency dependence of Zrs(ω=(2/ω tan⁻¹(1/ω)). The pulmonary hysteresivity (eta=G_(L)/H_(L)) is ameasure of the lung tissue composition, wherein both the tissue dampingand also the tissue elasticity are included (26, 27). For eachmeasurement the constant phase model is automatically tested for fit.The fit quality is represented as the coherence of the determination(COD), and the data are rejected if the COD is below 0.85.

Analysis of the Surfactant Protein

The total protein content of the lavage supernatants was determined withthe Bio-Rad protein assay kit (Bio-Rad). 10 μg of total protein wereseparated under non-reducing conditions on NuPage 10% bis-tris gelsusing a NOVEX Xcell II mini-cell system (Novex). After theelectrophoresis, the proteins were transferred onto a PVDF membrane(ImmobilonP) with a NuPage blot module (Novex). Surfactant protein B(SP-B) was detected with polyclonal rabbit antiserum which was directedagainst SP-B (c329, gift from Dr W. Steinhilber, Atlanta AG) and animproved chemiluminescence test (Amersham Biosciences) was thenperformed with horseradish peroxidase conjugated polyclonal goatanti-rabbit anti-IgG (1:10 000, Dianova). Under these conditions, thetest could detect about 2.5 ng of SP-B per track (28). As thechemiluminescence detection system, DIANA III dev. 1.0.54 with the Aidaimage analyzer (Ray test Isotopenmessgeräte GmbH) was used and the datawere quantitatively assessed with Quantity One 4.6.7 (Bio-Rad).

Fluorescence Microscope Analysis

Sections fixed (3% paraformaldehyde) and embedded in paraffin wax weresubjected to immunohistochemistry as recommended by the manufacturer(Abcam, www.abcam.com/technica). The slides were incubated withanti-human anti-mouse SP-B antibody and with Texas red-conjugatedanti-rabbit IgG antibody (both from Abcam, 1:500) and counterstainedwith DAPI. Fluorescent images were obtained by Zeiss Axiovert 135.

Statistics

Differences in mRNA expression between groups were analyzed by pairwisefixed reallocation randomization tests with REST 2005 software (29). Thehalf-lives for the decay of the bioluminescence were calculated withPrism 5.0. All other analyses were performed using theWilcoxon-Mann-Whitney test with SPSS 15 (SPSS Inc.). The data are statedas mean value±SEM (standard error of the mean value) or as median±IQR(interquartile ranges) and P<0.05 (two-sided) was regarded asstatistically significant.

EXAMPLE 6 mRNA Multiply Modified According to the Invention WhichEncodes EPO

With a method essentially as described in example 3, modified mRNA wasproduced which contained an EPO-encoding part. The expression efficiencyof this mRNA was tested. For this, 5 μg of mRNA modified according tothe invention or of non-modified mRNA were injected i.m. into mice. Eachgroup of mice had four members. On day 14 and day 28 afteradministration of the RNA, the content of EPO in the serum was assessedquantitatively with an ELISA test. The hematocrit value was assessed inwhole blood from mice in the same experiment. The data shown in theappended FIG. 11 each represent the mean value±SEM. The scatter blotshows the individual hematocrit values. Bars show median values. *P<0.05compared to the untreated group at each time point; +P<0.05 compared tothe unmodified mEPO group at each time point.

(c) The data show the mean value±SEM. Human PBMCs were transfected with5 μg of unmodified or modified RFP mRNA and the recovery rates weredetermined with RIP using antibodies specific for TLR-3, TLR-7 andTLR-8. The boxes signify mean values±IQR. The lines show the minimum andmaximum values. *P<0.5, **P<0.01, ***P<0.001 compared to unmodified mEPOgroup.

(d) 5 μg of unmodified and modified mEPO mRNA were injectedintravenously into mice (n=4 for each). After 24 hours, theinterferon-γ, IL-12 and interferon-α levels in the serum were assessedquantitatively by ELISA.

As can be seen from the diagrams, for the RNA modified according to theinvention the inflammatory markers are in the non-pathological range,while for unmodified RNA or modified RNA only with modified uridinenucleotides the inflammatory markers are markedly elevated.

Thus according to the invention an mRNA which encodes EPO is providedwhich is very stable and at the same time causes few or no immunologicalreactions. Such an mRNA can advantageously be used for the treatment oferythropoietin deficiency. Because of the high stability, administrationis only necessary every 2 to 4 weeks.

EXAMPLE 7

It was investigated how the repeated administration of EPO-encoding mRNAmodified according to the invention affects the hematocrit values. Thiswas to show whether the mRNA modified according to the invention alsoremains active over a longer period when it is administered into thebody. An immunological reaction to the mRNA according to the inventionwould for example decrease the activity.

Hence 10 μg of modified mEPO mRNA (as described in example 6) wereadministered to mice intramuscularly on days 0, 21 and 34 (n=10). Thehematocrit value was then determined in the whole blood from the mice ondays 0, 21, 34, 42 and 51. The results are shown in FIG. 14. The data inthe diagram show the mean±standard error. *P<0.05 compared to thehematocrit value on day 0.

The results confirm that repeated administration of the mRNA modifiedaccording to the invention leads to a long-lasting elevation of thehematocrit value. This shows that the mRNA remains active, even when itis administered many times.

EXAMPLE 8

mRNA modified according to the invention is also suitable for bringingproteins promoting healing or ingrowth into the vicinity of implants inorder thus to promote the healing process or the ingrowth. In order toshow that the mRNA modified according to the invention is stably andlastingly expressed when it is applied in the form of a coating ontitanium surfaces, a coating which contained mRNA which encodedluciferase was applied onto titanium plates. It was then investigatedwhether and for how long luciferase could be detected in the vicinity,free or in cells.

Two sequences encoding different proteins were used for the experiment,namely an RNA for luciferase which is secreted from the cell expressingit, as a model for proteins which are to be released into the vicinity,such as for example growth factors or angiogenesis factors. Further, RNAwhich encodes a luciferase which is not secreted but remains in the cellwas used as a model for proteins which are to have some kind of effectin the cell. For the secretion model, RNA which encoded Metridialuciferase was used, wherein compared to the wild type 25% of theuridine units were replaced by s2U and 25% of the cytidine units werereplaced by m5C. For the non-secretion protein model, a fireflyluciferase-encoding mRNA was used wherein likewise 25% of the uridineunits were replaced by s2U and 25% of the cytidine units were replacedby the modified m5C.

It was found that the mRNA preparations according to the invention,which were protected as a complex with polymer, after release from thecoating material remained active and were expressed over a prolongedperiod. It was found that the respective protein encoded by the mRNAmodified according to the invention could be detected over a prolongedperiod.

For the tests, the mRNA modified according to the invention, protectedby a polymer complex, was embedded in a carrier material which wasapplied as a layer onto titanium plates. The carrier material waspolylactide (PDLLA), a well-known material for this purpose, which canselectively release the contained mRNA gradually. An advantage of such acoating is that the release can be specifically adjusted. The resultsshow that the polylactide fragments released on degradation do notimpair the activity of the mRNA, so that this system is very suitable.The mRNA itself is stabilized by a coating polymer.

For the experiments, Metridia luciferase-encoding plasmid DNA (pDNA) ormodified mRNA was used. 9 μg respectively of Metridia luciferase pDNA ordoubly modified s2U_((0.25))m5C_((0.25)) mRNA in 200 μl of H₂O (+ifnecessary 500 μg of lactose) were complexed with 9.4 μg of L-PEI(L-polyethyleneimine) in 200 μl of H₂O. After this, the complexes wereintroduced into 100 μl of a coating polymer solution (2.4 μl of 409.1 mMP6YE5C) and lyophilized overnight (the coating polymer P6YE5C wasprepared as described in EP 11 98 489). After this, the complexes weresuspended in 72 μl of a PDLLA (poly-DL lactide)/EtOAc (50 mg/ml PDLLA)mixture on ice and dispersed by means of a micropotter. Autoclavedtitanium plates (r=3 mm, 18 μl each) in a 96-well plate were coated withthis dispersion. After a further lyophilization overnight, A549 cells in200 μl of RPMI-1640 medium were added (5000 cells/200 μl). From thesecond day, 50 μl of the supernatant were taken in each case, the mediumchanged and the Metridia luciferase expression determined on thefollowing days by means of 100 μl of coelenterazine solution (0.003 mMfinal concentration) for each.

In a further experiment, the activity of the Metridialuciferase-encoding mRNA modified according to the invention was testedwhen this had been deposited onto calcium phosphate particles andintroduced into the coating in this form. For this, 4 μg of Metridialuciferase s2U_((0.25))m5C_((0.25)) mRNA in 600 μl of 1×HES were mixedeach time with 33 μl of 2.5M CaCl₂. After 30 mins, autoclaved titaniumplates (r=3 mm, 18 μl each) in a 96-well plate were coated with this.After lyophilization overnight, A549 cells in 200 μl of RPMI-1640 mediumwere added (5000 cells/200 μl). From the second day, 50 μl of eachsupernatant were taken, the medium changed and the Metridia luciferaseexpression determined on the following days by means of 100 μl ofcoelenterazine solution (0.003 mM final concentration) for each.

The results can be seen in the diagram in FIG. 15. The results showclearly that mRNA modified according to the invention stays active evenwhen it is protected with a polymer coating, introduced into a delayedrelease matrix and applied onto titanium implants. Moreover the mRNAmodified according to the invention remains biologically active and iscontinuously translated into the encoded protein. The secretion capacityis also retained, which is seen from the fact that the Meridialuciferase can be detected in the cell culture medium (as a model forsecreted bone growth factors such as for example BMP-2). In addition,the results surprisingly show that the coating with modified mRNA yieldshigher protein expression than the coating of titanium implants with theanalogous plasmid DNA. When the mRNA/PEI complexes are provided with acoating polymer before the incorporation into the titanium implantcoating, still higher protein expression is obtained than with the useof the same complexes, but without coating polymer (in the figure mod.mRNA/IPE1-P6YE5C). Moreover it was found that the addition of lactose asan additive is possible without the modified mRNA losing its biologicalactivity.

The results also show that modified mRNA precipitated onto calciumphosphate particles retains its activity and can exercise itsadvantageous properties in the titanium implant coating. The biologicalactivity is retained. This is of particular importance since calciumphosphate can be directly incorporated into the bone.

As indicated above, a further experiment was performed with fireflyluciferase-encoding DNA or RNA. For this, 9 μg of firefly luciferasepDNA or modified s2U_((0.25))m5C_((0.25)) mRNA respectively in 200 μl ofH₂O were complexed with 9.4 μg of L-PEI in 200 μl of H₂O. After this,the complexes were introduced into 100 μl of a coating polymer solution(2.4 μl of 409.1 mM P6YE5C) and lyophilized overnight. Next, thecomplexes were dissolved in 72 μl of a poly-DL-lactic acid (PDLLA)/ethylacetate (EtOAc) (50 mg/ml PDLLA) mixture on ice and dispersed by meansof a micropotter. Autoclaved titanium plates (r=3 mm, 18 μl each) in a96-well plate were coated with this dispersion. After a furtherlyophilization overnight, A549 cells in 200 μl of RPMI-1640 medium wereadded (5000 cells/200 μl). On the second day, 1 μl of 350 μM D-luciferinwere added to each well, incubated for 20 mins and the luciferaseexpression determined by bio-imaging. The results are shown in FIG. 16.As can be seen from the diagram on FIG. 16, titanium implants can becoated with mRNA modified according to the invention during which themRNA also further remains biologically active and translates the encodedprotein. The protein formed remains in the cell and can be detectedintracellularly. In addition, the results show that the coating withmodified mRNA leads to higher protein expression than the coating oftitanium implants with the analogous plasmid DNA.

EXAMPLE 9

In order to control the expression of the mRNA modified according to theinvention so that the encoded protein is only expressed in cells inwhich it is wanted, but not in other cells, a micro-RNA binding site wasincorporated into the mRNA in order to enable cell-specific regulationof the mRNA expression.

For this, HEK293 cells were cultured in MEM with 10% FCS and 1%penicillin-streptomycin. 24 hrs before the transfection, 100 000cells/well, were sown into a 24-well plate. Directly before thetransfection, the medium was replaced by 400 μl of Optimem (Invitrogen).U937 cells were cultured in RPMI-1640 medium with 10% FCS and 1%penicillin-streptomycin. Directly before the transfection 800 000 U937cells in 400 μl of Optimem medium (Invitrogen) per well were sown into a24-well plate. For each well, 100 ng of EGFP mRNA and 250 ng of RFPmiRNA-BS mRNA (see below) were diluted to 50 μl with Optimem. 2 μl ofLipofectamine 2000 were made up to 50 μl with Optimem and incubated for5 mins at room temperature. Next the mRNA solution was pipetted into theLipofectamine 2000 solution and incubated for a further 20 mins at roomtemperature. The resulting solution was pipetted into the wells with thecells and after 4 hrs penicillin-streptomycin (5 μl) was added and theincubation continued overnight in the incubator. After this, the HEK293cells were washed with PBS and detached from the floor of the wells byaddition of trypsin before being centrifuged for 5 mins at 300 G. TheU937 cells were also centrifuged for 5 mins at 300 G. The supernatantwas removed and the respective cells then washed twice with PBS. Nextthe cells were resuspended in 500 μl of PBS for the FACS analysis. Inthe two diagrams of FIG. 17, the ratio of the expression of EGFP to theexpression of RFP is shown as the number of positive cells (FIG. 17 a)and as the mean RFP fluorescence intensity (FIG. 17 b).

The results show that by the incorporation of a micro-RNA binding siteinto in vitro transcribed mRNA the expression can be cell-specificallyregulated. In the RFP miRNA-BS mRNA, the untranslated sequence of afourfold repetition of a micro-RNA binding site, which are separatedfrom one another by short spacing sequences, is situated 3′ from the RFPsequence and 5′ from the polyA tail (SEQ ID No. 1). A micro-RNA bindingsite which binds to the micro-RNA 142-3p was used. This micro-RNA isexpressed in hematopoietic cells such as U937 cells, but not in cells ofother origin, such as HEK-293 cells. When micro-RNA 142-3p binds to theRFP miRNA-BS mRNA, e.g. in the U937 cells, the degradation of the mRNAis initiated by RNA interference. As a result the formation of RFP isdecreased, i.e. fewer cells express RFP at lower intensity than in cellsin which micro-RNA 142-3p is not present. In order to show that thisprinciple also functions well with the mRNA modified according to theinvention, U937 and HEK-293 cells were each co-transfected with EGFPmRNA (without micro-RNA binding site) and RFP miRNA-BS mRNA (withfourfold tandem repetition of the micro-RNA binding site for themicro-RNA 142-3p) and the expression of EGFP and RFP then measured byFACS. Since the RFP miRNA-BS mRNA is degraded because of RNAinterference more rapidly in U937 cells than in HEK-293 cells, while theEGFP mRNA is equally stable in both cells, it is expected that the ratioof EGFP to RFP will be higher in HEK-293 cells than in U937 cells. Thiscould be confirmed in the experiments performed. The diagram showsclearly that the number of RFP-positive U937 cells after normalizationto the number of EGFP-positive cells is markedly lower than in HEK-293cells. The same applies for the quantity of RFP formed per cell. Theresults thus also show clearly that the scale of the biological activityof in vitro transcribed mRNA can be controlled after transfection incells by the incorporation of micro-RNA binding sites. The mRNAtranslation can thus be suppressed in cells in which the mRNAtranslation is undesired. Side effects can also be reduced thereby.

The mRNA used for the experiments in this example has the followingsequence (SEQ ID No. 1). The RFP sequence is shown with a graybackground. The underlined sequence shows the fourfold tandem repetitionof the micro-RNA binding site for the micro-RNA 142-3p with spacingsequences. After synthesis, the sequence was cloned into the vectorpVAX1 using BamHI-EcoRv.

GGATCC

CTAGAGTCGACTCCATAAAGTAGGAAACACTACACGATTCCATAAAGTAGGAAACACTACAACCGGTTCCATAAAGTAGGAAACACTACATCACTCCATAAAGTAGGAAACACTACACAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAGATATC

indicates data missing or illegible when filed

REFERENCES

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1-30. (canceled)
 31. A polyribonucleotide comprising, a sequence whichencodes a protein or protein fragment, wherein the polyribonucleotidecontains a combination of unmodified and modified nucleotides, wherein 5to 50% of the uridine nucleotides and 5 to 50% of the cytidinenucleotides are respectively modified uridine nucleotides and modifiedcytidine nucleotides.
 32. The polyribonucleotide of claim 31, whereinthe polyribonucleotide is mRNA, wherein optionally the mRNA is in vitrotranscribed mRNA (IVT mRNA).
 33. The polyribonucleotide of claim 31,wherein the RNA encodes a protein or protein fragment, a defect or lackwhereof can trigger a disease, which can moderate, prevent or cure anillness or which can contribute a beneficial or necessary function,and/or wherein 15 to 30%, preferably 7.5 to 25%, of the uridinenucleosides and 15 to 30%, preferably 7.5 to 25%, of the cytidinenucleosides are modified, and/or wherein it contains at least two typesof modified uridine nucleosides and/or at least two types of modifiedcytidine nucleosides, wherein optionally at least one type of themodified uridine nucleosides and/or cytidine nucleosides has as amodification a functional group for attachment of one or more functionbearers, wherein preferably the function bearer is a target sequence, aPEG group and/or a targeting ligand.
 34. The polyribonucleotide of claim31, wherein modified uridines are selected from 2-thiouridine,5-methyluridine, pseudouridine, 5-methyluridine 5′-triphosphate (m5U),5-idouridine 5′-triphosphate (15U), 4-thiouridine 5′-triphosphate (S4U),5-bromouridine 5′-triphosphate (Br5U), 2′-methyl-2′-deoxyuridine5′-triphosphate (U2′m), 2′-amino-2′-deoxyuridine 5′-triphosphate(U2′NH2), 2′-azido-2′-deoxyuridine 5′-triphosphate (U2′N3) and2′-fluoro-2′-deoxyuridine 5′-triphosphate (U2′F), and/or wherein themodified cytidines are selected from 5-methylcytidine, 3-methylcytidine,2-thio-cytidine, 2′-methyl-2′-deoxycytidine 5′-triphosphate (C2′m),2′-amino-2′-deoxycytidine 5′-triphosphate (C2′NH2),2′-fluoro-2′-deoxycytidine 5′-triphosphate (C2′F), 5-iodocytidine5′-triphosphate (15U), 5-bromocytidine 5′-triphosphate (Br5U) and2′-azido-2′-deoxycytidine 5′-triphosphate (C2′N3), and/or wherein it hasan m7GpppG cap and/or at least one IRES and/or a polyA tail at the 5′end.
 35. The polyribonucleotide of claim 31, for use for transcriptreplacement therapy.
 36. The polyribonucleotide of claim 31, wherein thepolyribonucleotide contains an mRNA sequence which encodes at least onefactor which is beneficial and supportive for the body in general or ina specific situation.
 37. The polyribonucleotide of claim 31, whereinthe polyribonucleotide contains an RNA sequence which encodes a growthfactor, angiogenesis factor, stimulator, inducer, an enzyme or anotherbiologically active molecule, and/or wherein it contains an mRNAsequence which encodes surfactant protein B (SP-B), EPO, ABCA3, BMP-2 ora fragment thereof, and/or further containing at least one targetsequence or a targeted sequence for endogenous micro-RNAs which are notexpressed in the target cell.
 38. The polyribonucleotide of claim 37,further comprising a sequence encoding SP-B, for use for the treatmentof respiratory distress syndrome in the newborn, or further comprising asequence encoding EPO, for use for the treatment of EPO deficiency, orwhich contains at least one sequence encoding a growth factor,angiogenesis factor, stimulator, inducer or an enzyme, for use for thecoating of an implant.
 39. A polyribonucleotide comprising, a sequencewhich encodes a protein or protein fragment, obtainable from anucleotide mixture of the nucleotides ATP, GTP, CTP and UTP, wherein 5to 50% of the cytidine nucleotides and 5 to 50% of the uridinenucleotides are modified.
 40. The polyribonucleotide of claim 39,wherein the polyribonucleotide is mRNA, wherein optionally the mRNA isin vitro transcribed mRNA (IVT mRNA).
 41. The polyribonucleotide ofclaim 39, wherein the RNA encodes a protein or protein fragment, adefect or lack whereof can trigger a disease, which can moderate,prevent or cure an illness or which can contribute a beneficial ornecessary function, and/or wherein 15 to 30%, preferably 7.5 to 25%, ofthe uridine nucleosides and 15 to 30%, preferably 7.5 to 25%, of thecytidine nucleosides are modified, and/or wherein it contains at leasttwo types of modified uridine nucleosides and/or at least two types ofmodified cytidine nucleosides, wherein optionally at least one type ofthe modified uridine nucleosides and/or cytidine nucleosides has as amodification a functional group for attachment of one or more functionbearers, wherein preferably the function bearer is a target sequence, aPEG group and/or a targeting ligand.
 42. The polyribonucleotide of claim39, wherein modified uridines are selected from 2-thiouridine,5-methyluridine, pseudouridine, 5-methyluridine 5′-triphosphate (m5U),5-idouridine 5′-triphosphate (15U), 4-thiouridine 5′-triphosphate (S4U),5-bromouridine 5′-triphosphate (Br5U), 2′-methyl-2′-deoxyuridine5′-triphosphate (U2′m), 2′-amino-2′-deoxyuridine 5′-triphosphate(U2′NH2), 2′-azido-2′-deoxyuridine 5′-triphosphate (U2′N3) and2′-fluoro-2′-deoxyuridine 5′-triphosphate (U2′F), and/or wherein themodified cytidines are selected from 5-methylcytidine, 3-methylcytidine,2-thio-cytidine, 2′-methyl-2′-deoxycytidine 5′-triphosphate (C2′m),2′-amino-2′-deoxycytidine 5′-triphosphate (C2′NH2),2′-fluoro-2′-deoxycytidine 5′-triphosphate (C2′F), 5-iodocytidine5′-triphosphate (15U), 5-bromocytidine 5′-triphosphate (Br5U) and2′-azido-2′-deoxycytidine 5′-triphosphate (C2′N3), and/or wherein it hasan m7GpppG cap and/or at least one IRES and/or a polyA tail at the 5′end.
 43. The polyribonucleotide of claim 39, for use for transcriptreplacement therapy.
 44. The polyribonucleotide of claim 39,characterized in that it contains an RNA sequence which encodes a growthfactor, angiogenesis factor, stimulator, inducer, an enzyme or anotherbiologically active molecule, and/or wherein it contains an mRNAsequence which encodes surfactant protein B (SP-B), EPO, ABCA3, BMP-2 ora fragment thereof, and/or further containing at least one targetsequence or a targeted sequence for endogenous micro-RNAs which are notexpressed in the target cell.
 45. A pharmaceutical compositioncomprising, at least one RNA of claim 31, together with pharmaceuticallyacceptable additives.
 46. The pharmaceutical composition of claim 45, ina form for intratracheal and/or pulmonary administration or in the formof a layer for application onto an implant, which optionallyadditionally comprises at least one perfluorocarbon for administrationbefore or during the administration of the RNA-containing composition,which preferably contains perfluorocarbon and s2U_((0.25))m5C_((0.25))SP-B mRNA.
 47. An implant, comprising, a coating of modified RNA ofclaim 31 in a delayed release polymer as carrier.
 48. The implant ofclaim 47, which is a dental implant, a hip endoprosthesis, kneeendoprosthesis or a vertebral fusion body.
 49. The implant of claim 47,wherein the carrier polymer contains at least one type of modified RNA,and/or wherein the carrier polymer contains RNA which encodes at leastone protein beneficial in connection with an implantation, and/orwherein the carrier polymer contains RNA which encodes one or moregrowth factors and one or more angiogenesis factors.
 50. The implant ofclaim 48, wherein the carrier polymer contains at least one type ofmodified RNA, and/or wherein the carrier polymer contains RNA whichencodes at least one protein beneficial in connection with animplantation, and/or wherein the carrier polymer contains RNA whichencodes one or more growth factors and one or more angiogenesis factors.51. A method for the screening of nucleotide sequences in order to testthe immunogenicity and expression quality, comprising, a) contacting anRNA sequence with at least one receptor selected from TLR3, TLR7, TLR8and helicase RIG-1; and b) measuring the binding capacity.